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Montana rates for HCPCS J0742

Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg

Facilitymedian $3 · 10th–90th $2–$70%20%10th90th$3Professionalmedian $2 · 10th–90th $2–$70%20%40%10th90th$2$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $6.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.88 / $2.88 / $2.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $2.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $2.57 / $7.41
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.57 / $7.41
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.88 / $2.88 / $2.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $3.72 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $2.57