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New Hampshire rates for HCPCS J0841

Injection, crotalidae immune F(ab')2 (equine), 120 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $5,495.41 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $5,370.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $12,882.50 / $21,379.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $5,623.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $4,897.79 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $4,897.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $8,128.31 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $7,585.78