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Pennsylvania rates for HCPCS J0695

Injection, ceftolozane 50 mg and tazobactam 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.12 / $17.78 / $26.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $8.91 / $12.59
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.32 / $9.77 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $9.33 / $9.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $15.49 / $15.49
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.12 / $16.98 / $26.92
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $8.91 / $25.12
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $7.59 / $10.47
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $7.59 / $10.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $12.30