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New Hampshire rates for HCPCS J0400

Injection, aripiprazole, intramuscular, 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.03 / $1.27 / $2.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $0.86 / $0.86
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.80 / $1.02