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New Hampshire rates for HCPCS J2995

Injection Streptokinase Per 250 000 Iu (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.69 / $79.69 / $98.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.69 / $79.69 / $79.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.50 / $79.50 / $79.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.50 / $79.50 / $79.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.50 / $79.50 / $79.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.69 / $90.69 / $90.69
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.69 / $87.66 / $111.57