Ampicillin and sulbactam injection, 3 g

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION

Payers reporting HCPCS J0295

Payer pricing summary

Low

Average

$88

Median

$37

High

$818

Payer rate distribution

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Filter by billing class

#
1	Wellmark fee schedule · outpatient · +17 other terms	33	$2	$3	$17	595%	300–552	$1 – $237
2	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	341	$7	$14	$84	580%	290–1,721	$0 – $2.1k
3	Cigna fee schedule · outpatient · +25 other terms	421	$3	$13	$43	324%	196–1,474	$0 – $918
4	Anthem fee schedule · outpatient · +25 other terms	134	$2	$7	$13	190%	106–547	$1 – $133
5	Caresource fee schedule · outpatient · +16 other terms	66	$2	$9	$13	145%	71–125	$0 – $76
6	UnitedHealthcare fee schedule · outpatient · +32 other terms	522	$3	$19	$106	558%	62–251	$0 – $5.2k
7	Aetna fee schedule · outpatient · +29 other terms	296	$4	$32	$233	717%	58–580	$0 – $12.1k
8	Bcbs Nd other · outpatient · +3 other terms	2	$3	$3	$0	0%	55–550	$3 – $3
9	Kaiser fee schedule · both · +17 other terms	45	$2	$5	$43	780%	21–210	$1 – $523
10	Florida Blue percent of total billed charges · bothfrom % of charges	1	$11	$11	$3	29%	18–45	$8 – $20
11	Medica fee schedule · outpatient · +16 other terms	76	$97	$12	$27	223%	6–60	$0 – $107
12	Bcbs Al facility · other · outpatient · +1 other terms	5	$119	$117	$109	93%	3–30	$2 – $392
13	Bcbs Ar percent of total billed charges · bothfrom % of charges	1	$6	$6	—	—	2–20	$6 – $6
14	Bcbs Ny percent of total billed charges · bothfrom % of charges	1	$95	$95	$97	103%	1–10	$29 – $263
15	Bcbs Wy other · both · +1 other terms	1	$48	$48	—	—	1–10	$48 – $48
16	Humana fee schedule · outpatient · +24 other terms	190	$3	$49	$395	807%	—	$0 – $13.2k
17	MultiPlan fee schedule · outpatient · +18 other terms	91	$61	$104	$207	198%	—	$0 – $1.7k
18	Highmark facility · fee schedule · outpatient · +15 other terms	56	$2	$25	$30	122%	—	$1 – $129
19	Molina fee schedule · outpatient · +24 other terms	52	$4	$31	$216	690%	—	$1 – $3.6k
20	Medcost percent of total billed charges · bothfrom % of charges · +5 other terms	44	$48	$52	$33	63%	—	$2 – $371
21	Medicaid facility · fee schedule · outpatient · +9 other terms	37	$8	$24	$60	250%	—	$1 – $282
22	First Health fee schedule · outpatient · +17 other terms	36	$47	$53	$42	79%	—	$2 – $311
23	Regence facility · fee schedule · both · +14 other terms	32	$3	$6	$7	118%	—	$1 – $47
24	Excellus facility · fee schedule · both · +8 other terms	31	$3	$5	$5	99%	—	$1 – $31
25	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +4 other terms	31	$67	$74	$67	90%	—	$1 – $437

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