Ampicillin and sulbactam injection, 3 g at Glendale Adventist Medical Center

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

INJECTION, AMPICILLIN SODIUM/SULBACTAM SODIUM, PER 1.5 GM

Glendale, CA

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How this price compares nationally

Glendale Adventist Medical Center’s median price of $104 is 584% above the median hospital's median price ($15), higher than 95% of the 2,336 hospitals reporting HCPCS J0295. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J0295 at Glendale Adventist Medical Center

Negotiated rates from the hospital’s own file: 10 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield blue cross exchange fee schedule · outpatient	$16	$16	—	—	—	$16 – $16
2	Blue Cross Blue Shield blue cross non-mcs fee schedule · outpatient	$18	$18	—	—	—	$18 – $18
3	Blue Cross Blue Shield blue cross mcs - all other plans fee schedule · outpatient	$22	$22	—	—	—	$22 – $22
4	Blue Cross Blue Shield blue shield medi-cal percent of total billed charges · outpatientfrom % of charges	$45	$45	$4	9%	—	$41 – $49
5	Blue Cross Blue Shield blue shield epn - all other plans percent of total billed charges · outpatientfrom % of charges	$72	$72	$6	9%	—	$66 – $79
6	UnitedHealthcare uhc jll csp percent of total billed charges · outpatientfrom % of charges	$76	$76	$7	9%	2–20	$69 – $82
7	UnitedHealthcare uhc all payer - all other plans percent of total billed charges · outpatientfrom % of charges	$80	$80	$7	9%	2–20	$73 – $86
8	UnitedHealthcare uhc hmo percent of total billed charges · outpatientfrom % of charges	$80	$80	$7	9%	2–20	$73 – $86
9	Blue Cross Blue Shield blue shield non epn percent of total billed charges · outpatientfrom % of charges	$83	$83	$7	9%	—	$76 – $90
10	Cigna cigna all other - all other plans percent of total billed charges · outpatientfrom % of charges	$89	$89	$8	9%	—	$82 – $97
11	Cigna cigna hmo percent of total billed charges · outpatientfrom % of charges	$89	$89	$8	9%	—	$82 – $97
12	Optum optum health - all other plans percent of total billed charges · outpatientfrom % of charges	$93	$93	$8	9%	—	$85 – $101
13	Optum optum health mcr adv percent of total billed charges · outpatientfrom % of charges	$93	$93	$8	9%	—	$85 – $101
14	First Health first health- all plans percent of total billed charges · outpatientfrom % of charges	$114	$114	$10	9%	—	$104 – $124
15	Phcs phcs- all plans percent of total billed charges · outpatientfrom % of charges	$128	$128	$11	9%	—	$117 – $139
16	Kaiser kaiser - all plans percent of total billed charges · outpatientfrom % of charges	$167	$167	$15	9%	—	$152 – $181
17	Medicaid medi-cal fee schedule · outpatient	$196	$196	$17	9%	—	$179 – $213
18	Molina molina mcal fee schedule · outpatient	$196	$196	$17	9%	—	$179 – $213
19	Aetna aetna - all plans fee schedule · outpatient	$457	$457	$40	9%	—	$417 – $496

Last updated: Jul 30, 2026

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