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New Hampshire rates for HCPCS J0122

Injection, eravacycline, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.29 / $1.29 / $2.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.55 / $2.34 / $5.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.30 / $1.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.33 / $1.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.36 / $2.11 / $4.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.30 / $1.30
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.10 / $1.40