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New Hampshire 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 / $2.92 / $5.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.11 / $4.70 / $11.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.74 / $4.24 / $8.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.33 / $2.61 / $3.78
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $2.54 / $3.23