| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $212.39 | $212.39 | $212.39 | |
United
| Professional | $168.76 | $180.30 | $270.45 | |
University Health Alliance
| Professional | $126.50 | $153.61 | $212.61 |
Injection Gonadorelin Hydrochloride Per 100 Mcg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
HMSA
| Professional | $212.39 | $212.39 | $212.39 | |
United
| Professional | $168.76 | $180.30 | $270.45 | |
University Health Alliance
| Professional | $126.50 | $153.61 | $212.61 |