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Wisconsin rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Facilitymedian $69 · 10th–90th $59$1740%20%40%10th90th$69Professionalmedian $58 · 10th–90th $47$980%20%40%10th90th$58$20.0$50.0$100.0$200.0$500.0

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
$60.26 / $87.10 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $97.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $97.72 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $74.13 / $107.15
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $87.10
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $79.43 / $104.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $79.43
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $61.66 / $117.49
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $426.58
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $81.28