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New Hampshire rates for HCPCS J1458

Injection, galsulfase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.51 / $566.16 / $1,011.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.92 / $864.89 / $2,223.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.51 / $508.76 / $508.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.96 / $508.76 / $508.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.79 / $826.23 / $1,570.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.76 / $508.76 / $508.76
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.77 / $469.45 / $597.48