go back

Maine rates for HCPCS J0695

Injection, ceftolozane 50 mg and tazobactam 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $22.39 / $22.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $8.91 / $10.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $10.47 / $28.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $9.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $10.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $20.89 / $22.39
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $9.12 / $22.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $8.91 / $12.88