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New Hampshire rates for HCPCS J7631

Cromolyn Sodium Inhalation Solution Administered Through Dme Unit Dose Form Per 10 Milligrams (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.32 / $0.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.44 / $0.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.53 / $0.66 / $1.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.44 / $0.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.44 / $0.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.73 / $1.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.44 / $0.44
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.77 / $3.32 / $12.91