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New Hampshire rates for HCPCS J9340

Thiotepa 15 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.36 / $767.10 / $1,111.64
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.24 / $879.75 / $1,349.46