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Arkansas rates for HCPCS J0742

Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.13 / $3.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $3.13 / $3.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.83 / $2.83 / $2.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $2.83 / $2.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.33 / $2.61 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $2.61 / $2.73