go back

Iowa rates for HCPCS J0695

Injection Ceftolozane 50 Mg And Tazobactam 25 Mg (Reinstated 01/01/2016) Injection Cefonicid Sodium 1 Gram (Del 12/31/01)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.46 / $10.46 / $20.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $10.46 / $17.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.21 / $8.21 / $10.27
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $11.98 / $17.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.12 / $9.13 / $10.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.08 / $9.13 / $12.22
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.44 / $12.16 / $19.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.49 / $9.39 / $15.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.27 / $13.27 / $13.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.25
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.13 / $9.13 / $9.13
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.13 / $9.13 / $9.13