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New Hampshire rates for HCPCS J2357

Injection Omalizumab 5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.56 / $45.43 / $81.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $44.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.59 / $75.81 / $194.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.56 / $44.60 / $44.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.07 / $44.60 / $44.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $44.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.79 / $72.43 / $137.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $44.60 / $44.60
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.07 / $24.61 / $37.17