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New Hampshire rates for HCPCS Q4074

Iloprost Non-Comp Unit Dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.91 / $158.91 / $190.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.91 / $158.91 / $158.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.99 / $238.38 / $654.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.91 / $158.91 / $158.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.91 / $158.91 / $158.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.91 / $158.91 / $158.91
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.91 / $264.60 / $523.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.08 / $158.91 / $158.91
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.85 / $104.34 / $132.79