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North Carolina 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
$180.72 / $180.72 / $243.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.47 / $180.72 / $211.76
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.72 / $191.56 / $233.87
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.98 / $201.98 / $201.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $234.39
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.61 / $212.61 / $212.61