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New Hampshire rates for HCPCS A4802

Protamine Sulfate For Hemodialysis Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.99 / $13.58 / $13.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.92 / $17.98 / $19.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.15 / $13.58 / $13.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $2.25 / $4.54