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Maine 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
$9.42 / $21.04 / $22.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.43 / $11.05 / $11.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.77 / $11.02 / $28.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $10.98
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.04 / $21.04 / $22.68
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.43 / $11.05 / $22.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $13.15