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Pennsylvania rates for HCPCS J1000

Injection, depo-estradiol cypionate, up to 5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.69 / $109.77 / $142.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.38 / $49.77 / $63.04
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.44 / $53.46 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.14 / $51.14 / $51.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.49 / $49.28 / $49.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.28 / $49.28 / $49.28
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.38 / $80.06 / $142.61
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.38 / $49.77 / $142.61
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.49 / $49.28 / $49.28
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.28 / $49.28 / $49.28
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.70 / $29.70 / $34.46
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.70 / $29.70 / $34.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.28 / $49.28 / $68.06