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Massachusetts 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 / $5.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.71 / $3.13
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.38 / $6.99 / $85.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $2.61 / $3.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.80 / $3.33 / $7.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.11 / $83.43 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $5.42
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $85.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $2.61 / $3.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $2.61 / $3.92