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Arkansas rates for HCPCS J1620

Injection Gonadorelin Hydrochloride Per 100 Mcg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.72 / $180.72 / $180.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.47 / $176.47 / $180.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$187.51 / $187.51 / $187.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.51 / $187.51 / $187.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.09 / $48.09 / $187.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $191.73