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New Hampshire rates for HCPCS J1595

Injection, glatiramer acetate, 20 mg

Facilitymedian $81 · 10th–90th $63–$2290%10%10th90th$81Professionalmedian $63 · 10th–90th $60–$1170%50%10th90th$63$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $70.79 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $63.10 / $63.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $131.83 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $134.90 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $162.18