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New Hampshire rates for HCPCS J0200

Alatrofloxacin Mesylate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.03 / $17.03 / $20.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.03 / $17.03 / $17.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $16.98 / $16.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $20.04 / $20.04