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New Hampshire rates for HCPCS J0791

Injection Crizanlizumab-Tmca 5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.58 / $145.13 / $259.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.33 / $233.06 / $587.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.15 / $129.47 / $129.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.85 / $210.28 / $399.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.94 / $135.22 / $172.12