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New Hampshire rates for HCPCS J9281

Mitomycin pyelocalyceal instillation, 1 mg

Rates data updated October 2026.

How much does Jelmyto (mitomycin) cost?

$331per mg

Typical physician fee. In New Hampshire, October 2026.

Insurers have agreed to pay about $331 for each mg of this drug. Most negotiated rates run $331 to $331.

Work out the cost of a dose

This drug is priced per mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$331

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $617 · 10th to 90th $417 to $1,413Professionalmedian $331 · 10th to 90th $324 to $339
$500$1Kfacility $617professional $331

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$416.87
Median
$616.60
Typical High
$1,412.54
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$338.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$645.65
Typical High
$870.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$331.13
Typical High
$398.11
United
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$323.59
Typical High
$338.84
Well Sense
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$33.11
Median
$33.11
Typical High
$33.11

Where New Hampshire sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 50th of 51

$331

AK $407VT $331

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.