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New Hampshire rates for HCPCS J0121

Injection, omadacycline, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $4.68 / $8.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $4.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.62 / $10.96 / $18.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $4.27 / $4.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $4.27 / $4.27
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $6.92 / $7.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $6.31