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New Hampshire rates for HCPCS J0401

Injection, aripiprazole (Abilify Maintena), 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $8.13 / $14.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $19.05 / $31.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $8.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $7.24 / $7.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $7.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $12.02 / $13.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $11.22