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Missouri rates for HCPCS J0743

Injection, cilastatin sodium; imipenem, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $14.13 / $17.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $14.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $10.47 / $18.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $10.23 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $7.08 / $7.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $13.18 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $6.92 / $8.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $9.77 / $11.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $7.08 / $8.91