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New Hampshire rates for HCPCS J7170

Injection Emicizumab-Kxwh 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.43 / $64.31 / $114.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $57.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.15 / $90.93 / $245.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $57.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.93 / $56.10 / $56.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $56.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $88.60 / $173.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.10 / $56.10 / $56.10
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.69 / $59.06 / $75.17