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Vermont rates for HCPCS J0742

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $4.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $2.95 / $2.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $2.83 / $4.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.46 / $2.83 / $4.71
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $2.61 / $2.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.61 / $2.77