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Utah rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Facilitymedian $68 · 10th–90th $68–$780%50%90th$68Professionalmedian $58 · 10th–90th $47–$680%20%40%10th90th$58$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $46.77 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54