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New Hampshire rates for HCPCS J2425

Injection Palifermin 50 Micrograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.90 / $40.22 / $71.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.37 / $63.99 / $161.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.54 / $35.54 / $35.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.29 / $57.73 / $109.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.54 / $35.54 / $35.54
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.18 / $26.60 / $33.85