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Indiana 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 / $170.09 / $765.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.09 / $170.09 / $170.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.30 / $180.30 / $347.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.25 / $180.30 / $243.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,874.72 / $32,812.17 / $39,374.61
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34,124.66 / $34,124.66 / $34,124.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $238.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $225.47