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New Hampshire rates for HCPCS 79403

Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $190.55 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $245.47 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $407.38 / $630.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $309.03 / $478.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $275.42 / $524.81