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New Hampshire rates for HCPCS J1097

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Facilitymedian $186 · 10th–90th $120–$9330%10%20%10th90th$186Professionalmedian $120 · 10th–90th $112–$2240%50%10th90th$120$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $134.90 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $120.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $251.19 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $120.23 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $257.04 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $199.53 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $117.49 / $181.97