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Rhode Island rates for HCPCS J0743

Cilastatin Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.31 / $33.31 / $33.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $6.97 / $12.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.67 / $10.25 / $10.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $17.02