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North Dakota rates for HCPCS J0743

Cilastatin Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.25 / $10.25 / $12.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $10.25 / $10.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.12 / $11.18 / $11.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.44 / $11.16 / $11.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $7.54 / $9.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $7.93 / $15.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $6.97 / $7.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.92 / $10.25 / $11.13