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Massachusetts rates for HCPCS J0743

Cilastatin Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.25 / $10.25 / $20.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $10.25 / $10.66
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $31.39 / $75.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $15.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.00 / $13.08 / $27.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.20 / $53.00 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $21.73
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $15.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $15.83