go back

Oregon 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
$212.61 / $212.61 / $425.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.47 / $176.47 / $212.61
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.47 / $252.35 / $379.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.87 / $13,910.16 / $18,772.80
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.30 / $180.30 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.47 / $252.35 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.30