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Idaho 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 / $3.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.87 / $3.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $2.61 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.87 / $3.46 / $4.66
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.65 / $3.78 / $6.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.65