go back

New Jersey rates for HCPCS J0743

Injection, cilastatin sodium; imipenem, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.57 / $10.52 / $22.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.95 / $10.25 / $12.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.34 / $13,785.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $8.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $12.56