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New Hampshire rates for HCPCS J0120

Injection, tetracycline, up to 250 mg

Facilitymedian $16 · 10th–90th $14–$180%20%10th90th$16Professionalmedian $14 · 10th–90th $1–$740%20%10th90th$14$1.0$2.0$5.0$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $15.85 / $17.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $70.79 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $39.81 / $89.13