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New Hampshire rates for HCPCS J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.35 / $727.62 / $746.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $661.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.01 / $1,035.90 / $2,515.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $597.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.92 / $575.50 / $575.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $575.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $964.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $610.03
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.54 / $958.87 / $3,375.00