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Arkansas rates for HCPCS J0743

Injection, cilastatin sodium; imipenem, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.36 / $12.30 / $12.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $10.25 / $12.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.57 / $7.57 / $7.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.82 / $10.25 / $10.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $17.69