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New Hampshire rates for HCPCS J1364

Erythro Lactobionate /500 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.05 / $84.06 / $150.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $75.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.25 / $96.93 / $265.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $75.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.96 / $64.62 / $64.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.80 / $104.94 / $199.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.62 / $64.62 / $64.62
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.27 / $92.70 / $117.98