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New Hampshire rates for HCPCS J1742

Injection, ibutilide fumarate, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.61 / $310.61 / $382.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.18 / $536.94 / $930.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $310.60 / $310.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.61 / $310.61 / $310.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.15 / $333.02 / $632.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.30 / $298.30 / $298.30
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.27 / $361.93 / $536.73