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New Hampshire rates for HCPCS 80170

Gentamicin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.84 / $59.83 / $114.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.61 / $18.69 / $19.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.95 / $31.71 / $74.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.55 / $10.64 / $12.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.38 / $82.67 / $110.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $11.73 / $23.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.23 / $29.11 / $59.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.88 / $9.83 / $13.74
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.94 / $19.44 / $26.35