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Michigan 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
$2.69 / $2.69 / $8.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.69 / $3.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.34 / $5.79 / $10.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $2.65 / $2.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $3.36 / $7.48
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.69 / $3.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.87 / $2.87 / $3.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.77