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Vermont rates for HCPCS J0743

Cilastatin Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $11.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.60 / $11.60 / $11.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.31 / $9.67 / $13.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.31 / $9.67 / $13.84
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.25 / $10.25 / $10.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.74 / $10.25 / $15.77