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Connecticut 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
$2.71 / $4.09 / $7.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.71 / $2.71 / $2.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $3.97 / $7.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.71 / $2.83 / $3.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $2.61 / $2.90