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New Hampshire rates for HCPCS J1265

Injection, dopamine HCl, 40 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $2.24 / $2.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.66 / $2.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.79 / $0.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $1.32 / $1.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $1.23