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New Hampshire rates for HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.42 / $7.20 / $61.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.43 / $0.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.51 / $0.65 / $1.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.43 / $0.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.57 / $0.72 / $1.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.94 / $1.12 / $1.78