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New Hampshire rates for HCPCS J9203

Gemtuzumab ozogamicin 0.1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.62 / $283.94 / $291.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $246.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.88 / $425.92 / $1,034.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.22 / $236.62 / $236.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $236.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $396.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.62 / $236.62 / $250.82
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.19 / $226.81 / $288.67