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West Virginia rates for HCPCS J0695

Injection, ceftolozane 50 mg and tazobactam 25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.13 / $9.13 / $9.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $9.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.07 / $13.61 / $13.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.55 / $9.07 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.07 / $9.07 / $15.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.89 / $9.07 / $10.46