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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 / $1.45 / $2.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $3.39 / $5.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.32 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $2.14 / $2.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.95