go back

New Hampshire rates for HCPCS J9173

Injection, durvalumab, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.25 / $102.30 / $104.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $95.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.25 / $85.25 / $85.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.37 / $132.79 / $350.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $85.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.30 / $85.12 / $85.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $85.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $142.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.12 / $85.12 / $90.23
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.73 / $105.99 / $3,375.00