go back

Illinois 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
$170.09 / $344.43 / $569.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.09 / $170.09 / $180.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.00 / $641.70 / $2,700.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$486.81 / $486.81 / $486.81
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.20 / $116.50 / $288.56
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $191.35