Price of Ampicillin-Sulbactam Injection 1.5 Gram at NYU Langone
Last Updated: 2024-07-01
Locations
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NYU Langone|Tisch Hospital
550 1st Ave., New York, NY 10016About Ampicillin-Sulbactam Injection 1.5 Gram
Service Codes: HCPCS J0295, LOCAL 5010003
This injection is used to treat various bacterial infections by combining two antibiotics, ampicillin and sulbactam, which work together to fight bacteria and prevent them from becoming resistant to treatment.
Pricing Overview
Cash Price
$6.56
Median Price
$10.01
Price Range
$3.45 - $25.19
Insurance Plan Prices
| Insurance Provider | Plan Type | Price |
|---|---|---|
| EmblemHealth | HIP Medicare Supplement | $10.01 |
| Aetna | Starmark ASA PPO | $10.35 |
| Cigna | Cigna Managed Care/POS | $11.04 |
| UnitedHealthcare | Choice (NY Power Authority) | $3.45 |
| Aetna | Open Access HMO | $10.35 |
| EmblemHealth | Select Care Silver Small Group | $10.01 |
| UnitedHealthcare | Navigate | $3.45 |
| EmblemHealth | Prime Platinum | $10.01 |
| MultiPlan | Fiserv Health | $25.19 |
| Cigna | MVP-Cigna Network | $11.04 |
| MetroPlus | MedPlus | $10.70 |
| EmblemHealth | Healthcare Partners Essential Plan 3 | $10.01 |
| Aetna | Wellnet ASA PPO | $10.35 |
| Maksin Group | Consolidated Health Plan (Home-based only) | $11.04 |
| EmblemHealth | WLNY-TV | $13.80 |
| EmblemHealth | Prime Bronze | $10.01 |
| MultiPlan | Nippon Life | $25.19 |
| EmblemHealth | GHI Medicare HMO | $13.80 |
| UnitedHealthcare | Charter | $3.45 |
| EmblemHealth | Select Care HMO | $10.01 |
| MagnaCare | Cement & Concrete Workers District Council | $8.28 |
| EmblemHealth | Select Care Healthcare Partners | $10.01 |
| EmblemHealth | HIP Optum Health | $10.01 |
| MultiPlan | PHCS Savility | $25.19 |
| MultiPlan | Global Health Management | $25.19 |
| Cigna | PPO | $11.04 |
| EmblemHealth | HIP | $10.01 |
| Cigna | Tufts Health Plan | $11.04 |
| EmblemHealth | Essential Plan 1, 200-250 | $10.01 |
| EmblemHealth | HIP VIP Medicare Healthcare Partners | $10.01 |
| MagnaCare | PPO | $8.28 |
| MultiPlan | PHP Healthcare (Champus) | $25.19 |
| MagnaCare | American Plan Administrators | $8.28 |
| EmblemHealth | Select Care EPO | $10.01 |
| UnitedHealthcare | Choice (North Shore - LIJ) | $3.45 |
| Cigna | Evernorth Behavioral Health | $11.04 |
| MultiPlan | Administrative Concepts | $25.19 |
| Aetna | Chesterfield Resources ASA PPO | $10.35 |
| Aetna | PPO | $10.35 |
| EmblemHealth | Select Care Platinum Small Group | $10.01 |
| EmblemHealth | HIP Child Health Plus | $10.01 |
| EmblemHealth | CMO Essential Plan 1 | $10.01 |
| EmblemHealth | Healthcare Partners Essential Plan 4 | $10.01 |
| EmblemHealth | HIP compre health | $10.01 |
| EmblemHealth | GHI EPO | $13.80 |
| MetroPlus | Essential Plan 3 | $4.49 |
| EmblemHealth | Select Care Gold Small Group | $10.01 |
| EmblemHealth | GHI Behavioral Management Program | $13.80 |
| EmblemHealth | GHI Medicare Supplement | $13.80 |
| MetroPlus | GoldCare 2 | $6.90 |
| EmblemHealth | HIP Prime Basic | $10.01 |
| EmblemHealth | HIP Access I | $10.01 |
| Aetna | Healthscope ASA PPO | $10.35 |
| MultiPlan | AXA Global Insurance | $25.19 |
| Cigna | HMO | $11.04 |
| UnitedHealthcare | EPO | $3.45 |
| MultiPlan | PPO | $25.19 |
| MultiPlan | Capital District Physicians Health Plan | $25.19 |
| MetroPlus | Essential Plan 1-2, 200-250 | $6.56 |
| MetroPlus | SilverPlus | $10.70 |
| Cigna | Great West HMO | $11.04 |
| Cigna | Wellfleet Student | $11.04 |
| EmblemHealth | HIP VIP Medicare Affinity | $10.01 |
| Health Net | PPO | $25.19 |
| UnitedHealthcare | HMO | $3.45 |
| Aetna | HMO | $10.35 |
| EmblemHealth | HIP Montefiore | $10.01 |
| Aetna | Open Access Elect Choice EPO | $10.35 |
| EmblemHealth | GHI composite | $13.80 |
| EmblemHealth | Select Care Gold Exchange | $10.01 |
| Aetna | Meritain Health | $10.35 |
| EmblemHealth | HIP EPO | $10.01 |
| GEHA | All Plans | $10.35 |
| UnitedHealthcare | Choice | $3.45 |
| EmblemHealth | Healthcare Partners Essential Plan 1-2 | $10.01 |
| EmblemHealth | IUOE Local 14-14B | $13.80 |
| EmblemHealth | GHI Comprehensive Benefits Plan (CBP) | $13.80 |
| EmblemHealth | HIP HMO | $10.01 |
| MetroPlus | Gold | $6.90 |
| MetroPlus | BronzePlus | $10.70 |
| UnitedHealthcare - Oxford | Optum Health | $3.45 |
| EmblemHealth | Select Care Catastrophic Exchangeu00a0 | $10.01 |
| MultiPlan | Screen Actors Guild | $25.19 |
| MultiPlan | Meritain Health | $25.19 |
| MagnaCare | JIB Employees Security Fund | $8.28 |
| EmblemHealth | Prime Silver | $10.01 |
| UnitedHealthcare - Oxford | Liberty | $3.45 |
| UnitedHealthcare | POMCO (UMR) | $25.19 |
| Aetna | Nippon Life ASA PPO | $10.35 |
| EmblemHealth | Healthcare Partners Essential Plan 3-4 | $10.01 |
| EmblemHealth | HIP VIP Medicare Montefiore | $10.01 |
| Cigna | NALC PPO | $11.04 |
| EmblemHealth | Enhanced Care (Medicaid) | $10.01 |
| EmblemHealth | Select Care Silver Exchange | $10.01 |
| Cigna | Open Access | $11.04 |
| Cigna | Open Access PPO | $11.04 |
| EmblemHealth | Essential Plan 3 | $10.01 |
| UnitedHealthcare - Oxford | Freedom | $3.45 |
| EmblemHealth | HIP VIP Medicare Reserve | $10.01 |
| EmblemHealth | GHI PPO | $13.80 |
| EmblemHealth | HIP VIP Medicare Bold | $10.01 |
| MultiPlan | Kaiser Permanente | $25.19 |
| UnitedHealthcare | POS | $3.45 |
| MultiPlan | Diversified Admin Corp | $25.19 |
| EmblemHealth | GHI HMO | $13.80 |
| MagnaCare | JIB Members | $8.28 |
| MetroPlus | GoldPlus | $10.70 |
| MultiPlan | US Life Insurance Co | $25.19 |
| EmblemHealth | CMO Essential Plan 2 | $10.01 |
| MetroPlus | Essential Plan 2 | $6.56 |
| EmblemHealth | Select Care Basic Exchange | $10.01 |
| Aetna | Global National Transplant | $10.35 |
| Cigna | Open Access HMO | $11.04 |
| Cigna | Indemnity | $11.04 |
| Cigna | Great West PPO | $11.04 |
| Aetna | Christian Brothers ASA PPO | $10.35 |
| EmblemHealth | HIP PPO | $10.01 |
| EmblemHealth | American Plan Administrators c/o H.D.A | $13.80 |
| Aetna | Allied ASA PPO | $10.35 |
| UnitedHealthcare - Oxford | Metro | $3.45 |
| EmblemHealth | Select Care Bronze Small Group | $10.01 |
| EmblemHealth | Essential Plan 2 | $10.01 |
| EmblemHealth | American Plan Administrators | $13.80 |
| EmblemHealth | HIP compre health epo | $10.01 |
| MultiPlan | Healthnet of California | $25.19 |
| MultiPlan | PHCS | $25.19 |
| Aetna | Indemnity | $10.35 |
| MultiPlan | Teamsters Allied Benefits | $25.19 |
| MultiPlan | Humana Health Plan | $25.19 |
| EmblemHealth | HIP Access II | $10.01 |
| MetroPlus | Essential Plan 1 | $6.56 |
| MultiPlan | Principal Financial Group | $25.19 |
| MultiPlan | QualCare Inc | $25.19 |
| EmblemHealth | CMO Essential Plan 3 | $10.01 |
| EmblemHealth | Healthcare Partners Essential Plan 2 | $10.01 |
| EmblemHealth | Bridge | $10.01 |
| MetroPlus | Medicaid Managed Care | $4.49 |
| EmblemHealth | HIP POS | $10.01 |
| EmblemHealth | Healthcare Partners Essential Plan 1, 200-250 | $10.01 |
| EmblemHealth | HIP SmartStart | $10.01 |
| Aetna | Signature Administrators PPO | $10.35 |
| MultiPlan | Paramount Insurance | $25.19 |
| EmblemHealth | Vytra HMO | $10.01 |
| Aetna | Coresource ASA PPO | $10.35 |
| MagnaCare | Direct Plus | $8.28 |
| UnitedHealthcare | Golden Rule Insurance | $3.45 |
| MultiPlan | Guardian Life Insurance Co | $25.19 |
| EmblemHealth | Select Care PPOu00a0 | $10.01 |
| MagnaCare | Independent Care Plus | $8.28 |
| First Health | PPO | $25.19 |
| Aetna | Student Health | $10.35 |
| MetroPlus | Essential Plan 4 | $4.49 |
| UnitedHealthcare | POMCO (UMR) | $3.45 |
| Humana | All Commercial Plans | $25.19 |
| Aetna | POS | $10.35 |
| MetroPlus | PlatinumPlus | $10.70 |
| EmblemHealth | VIP Prime HMO Medicare Advantage | $10.01 |
| MultiPlan | Global Excel Management | $25.19 |
| EmblemHealth | CMO Essential Plan 4 | $10.01 |
| UnitedHealthcare | Independent | $3.45 |
| MetroPlus | Child Health Plus (CHP) | $4.49 |
| EmblemHealth | HIP Long Island College Hospital (LICH) | $10.01 |
| Cigna | Premier Plus | $11.04 |
| MagnaCare | Capital District Physicians Health Plan | $8.28 |
| UnitedHealthcare | PPO | $3.45 |
| MetroPlus | Essential Plan 3-4 | $4.49 |
| EmblemHealth | Select Care Bronze Exchange | $10.01 |
| EmblemHealth | HIP Healthcare Partners HMO | $10.01 |
| EmblemHealth | Prime Gold | $10.01 |
| MagnaCare | National Health Plan | $8.28 |
| MagnaCare | Direct Plus Preferred | $8.28 |
| EmblemHealth | Enhanced Care (Medicaid) Montefiore | $10.01 |
| Cigna | LifeSOURCE | $11.04 |
| MultiPlan | Mutual of Omaha | $25.19 |
| EmblemHealth | Enhanced Care (Medicaid) Healthcare Partners | $10.01 |
| UnitedHealthcare | Optum Health | $3.45 |
| EmblemHealth | GHI Medicare PPO | $13.80 |
| UnitedHealthcare | Student Resources | $3.45 |
| EmblemHealth | Healthcare Partners Essential Plans | $10.01 |
| EmblemHealth | Essential Plan 4 | $10.01 |
| EmblemHealth | Select Care Platinum Exchange | $10.01 |
| MultiPlan | PHCS Director Guild | $25.19 |
| UnitedHealthcare | Core | $3.45 |