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Washington, DC rates for HCPCS J0743

Cilastatin Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.25 / $19.66 / $26.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $10.76 / $18.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.67 / $9.67 / $10.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $8.71 / $10.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $10.25 / $16.61