go back

Tennessee rates for HCPCS J0743

Injection, cilastatin sodium; imipenem, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $10.25 / $14.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $10.25 / $10.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.89 / $12.89 / $12.89
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $15.83