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New Hampshire rates for HCPCS J9040

Bleomycin Sulfate 15 Units (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.90 / $21.53 / $134.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $21.53 / $25.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.74 / $32.29 / $43.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $21.53 / $21.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.30 / $21.52 / $21.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.52 / $21.52 / $21.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $21.53 / $37.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $21.53 / $24.11
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.30 / $282.85 / $433.87