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New Hampshire rates for HCPCS A4802

Protamine sulfate, for hemodialysis, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.88 / $15.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $20.89 / $20.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $13.49 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $2.24 / $4.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $2.24 / $4.47