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Montana 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
Professional
Modifier
Low / Median / High Price
$9.88 / $11.05 / $17.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.18 / $9.18 / $19.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.18
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.18 / $9.18 / $19.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.83 / $12.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.07