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New Hampshire rates for HCPCS J2515

Injection Pentobarbital Sodium Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.87 / $53.87 / $66.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $53.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.98 / $79.23 / $105.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.82 / $53.87 / $53.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.87 / $53.87 / $53.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.87 / $53.87 / $53.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.71 / $36.70 / $69.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.82 / $52.82 / $52.82
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.44 / $23.58 / $30.02