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New Hampshire rates for HCPCS J1562

Injection, immune globulin (Vivaglobin), 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.24 / $12.24 / $15.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.24 / $12.24 / $12.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.25 / $7.25 / $7.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.40 / $14.40 / $16.13
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.69 / $10.66 / $13.57