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New Hampshire rates for HCPCS J7201

Injection Factor Ix Fc Fusion Protein (Recombinant) Alprolix 1 I.U. (Desc Revised 1/1/2017)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $4.07 / $7.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.23 / $5.82 / $15.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $3.59 / $3.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.59
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.53 / $5.59 / $11.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.59
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.82 / $3.10 / $3.95