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New Hampshire rates for HCPCS J1301

Injection, edaravone, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.38 / $19.50 / $34.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $17.38 / $19.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $45.71 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $17.38 / $17.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $17.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $25.12 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $26.92