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Hawaii 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
$4.76 / $4.76 / $4.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.65 / $3.65 / $3.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.87 / $3.13 / $3.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $3.00 / $3.92
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.38 / $3.03 / $3.23