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New Hampshire rates for HCPCS J0179

Inj, brolucizumab-dbll, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.19 / $387.73 / $692.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.11 / $346.11 / $346.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.13 / $571.39 / $1,512.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.11 / $346.11 / $346.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.52 / $346.11 / $346.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.11 / $346.11 / $346.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.14 / $562.08 / $1,068.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.11 / $346.11 / $346.11
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.50 / $345.95 / $440.30