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New Hampshire rates for HCPCS J0275

Alprostadil urethral suppository (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $46.77 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $40.74 / $41.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $42.66 / $70.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $28.84 / $35.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $70.79 / $70.79