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Hawaii rates for HCPCS J1620

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

Insurance Carrier
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.39 / $212.39 / $212.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.76 / $180.30 / $270.45
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.50 / $153.61 / $212.61