go back

New Hampshire rates for HCPCS J0720

Injection Chloramphenicol Sodium Succinate Up To 1 Gm (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.62 / $49.62 / $61.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $49.62 / $49.62
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.16 / $72.98 / $200.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.65 / $49.62 / $49.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.62 / $49.62 / $49.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.62 / $49.62 / $49.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.20 / $83.68 / $155.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.65 / $48.65 / $48.65
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.70 / $43.67 / $55.58