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New Hampshire rates for HCPCS J1570

Injection, ganciclovir sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.61 / $44.37 / $79.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.27 / $59.31 / $162.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.29 / $39.54 / $39.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.66 / $65.83 / $122.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.54 / $39.54 / $39.54
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.96 / $35.95 / $52.85