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New Hampshire rates for HCPCS J2315

Injection Naltrexone Depot Form 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.24 / $4.75 / $8.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.05 / $7.63 / $19.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.24 / $4.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $6.89 / $13.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.24
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.83 / $3.31 / $4.99