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Utah rates for HCPCS J0695

Injection, ceftolozane 50 mg and tazobactam 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $8.91 / $10.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $11.48 / $12.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $13.18 / $28.18
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $9.12 / $9.12
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $9.12 / $10.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91