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New Hampshire rates for HCPCS J1630

Injection Haloperidol Up To 5 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.80 / $2.17 / $13.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $1.20 / $3.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.80 / $0.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.33 / $2.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.80 / $0.94
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $2.00 / $3.03