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New Hampshire rates for HCPCS J1956

Injection, levofloxacin, 250 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.35 / $7.20 / $43.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.54 / $2.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.81 / $10.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.54 / $2.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.39 / $2.54 / $2.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $2.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $4.23 / $7.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $2.54 / $5.08
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.24 / $9.19 / $14.75