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New Hampshire rates for HCPCS J2406

Injection, oritavancin (Kimyrsa), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.40 / $46.37 / $82.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.63 / $76.45 / $192.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $42.48 / $42.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.07 / $42.48 / $42.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.57 / $68.98 / $131.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $42.48
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.51 / $45.66 / $58.11