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Arizona 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
$227.49 / $425.22 / $637.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.21 / $172.21 / $206.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.37 / $212.61 / $246.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.30