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New Hampshire rates for HCPCS J1459

Injection, immune globulin (Privigen), intravenous, nonlyophilized (e.g., liquid), 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.43 / $56.48 / $4,587.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.74 / $50.74 / $50.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.83 / $86.26 / $221.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.43 / $50.74 / $50.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.87 / $50.74 / $50.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.74 / $50.74 / $50.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.24 / $82.40 / $156.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.74 / $50.74 / $56.83
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.52 / $37.97 / $57.37