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New Hampshire rates for HCPCS J1580

Injection, garamycin, gentamicin, up to 80 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.20 / $7.17 / $79.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.21 / $2.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.64 / $3.32 / $9.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.08 / $2.21 / $2.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.21
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.68 / $6.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.21 / $2.21 / $2.21
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.13 / $1.80