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Indiana 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
$2.63 / $6.02 / $11.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.63 / $2.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $5.22 / $6.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.61 / $3.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.39 / $2.61 / $6.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.26