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New Hampshire rates for HCPCS J3101

Injection, tenecteplase, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.94 / $172.21 / $343.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.27 / $310.00 / $781.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.94 / $172.22 / $172.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.47 / $172.22 / $172.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.69 / $279.69 / $531.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.22 / $172.22 / $172.22