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Georgia 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
$2.61 / $2.61 / $3.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $4.25 / $9.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.61 / $2.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $5.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $2.46 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $17.00 / $26.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.03