go back

New Hampshire rates for HCPCS J9313

Injection Moxetumomab Pasudotox-Tdfk 0.01 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.51 / $25.21 / $27.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.27 / $22.51 / $23.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.38 / $39.76 / $102.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $22.50 / $22.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.51 / $22.51 / $22.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $22.51 / $22.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.39 / $23.39 / $39.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $22.07 / $23.39
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $24.76 / $31.51