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New Hampshire rates for HCPCS C9091

Injection, sirolimus protein-bound particles, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.20 / $69.20 / $83.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.20 / $69.20 / $69.20
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.20 / $2,500.00 / $3,500.00