go back

New Hampshire rates for HCPCS J1620

Injection, gonadorelin HCl, per 100 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.72 / $180.72 / $222.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.72 / $180.72 / $180.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.30
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.72 / $198.79 / $253.01