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Ohio 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 / $5.66 / $8.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.64 / $6.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.82 / $4.55 / $7.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $4.51
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $2.61 / $4.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $2.46 / $2.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.95
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $3.26 / $3.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $3.63