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New Hampshire rates for HCPCS J7121

5% Dextrose In Lac Ringers

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.10 / $8.14 / $78.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.53 / $11.97 / $32.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $8.14 / $8.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.14 / $8.14 / $8.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.05 / $13.55 / $25.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.98 / $7.98 / $7.98
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.58 / $8.22 / $3,000.00