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Iowa 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
$3.03 / $3.03 / $5.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $3.03 / $5.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $3.19
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $4.72 / $14.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $3.00 / $3.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.75 / $5.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.85 / $3.13 / $3.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.87
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61