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Wisconsin 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 / $13.49 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $15.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.22 / $11.22 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $11.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $16.98 / $29.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $11.48 / $16.60
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $9.12 / $19.95
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $18.20 / $18.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $9.12 / $19.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.12 / $14.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $9.77 / $29.51
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $95.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $12.02 / $14.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $8.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $12.30