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Missouri 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 / $170.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.09 / $170.09 / $170.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $212.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.24 / $188.24 / $188.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.09 / $212.61 / $477.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.26 / $180.30 / $207.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.26 / $180.30 / $208.36