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North Dakota 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 / $382.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.09 / $212.61 / $212.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.38 / $186.38 / $232.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.09 / $212.61 / $289.14
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $195.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.26 / $180.30 / $201.94