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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
$4.01 / $4.01 / $8.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.79 / $7.24 / $18.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.79 / $4.09 / $4.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.22 / $6.53 / $12.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.01 / $4.01 / $4.01
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.96 / $4.36 / $5.54