| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.98 | $690.98 | $690.98 | |
Aetna
| Professional | $170.09 | $170.09 | $180.72 | |
BCBS
| Facility | $12.31 | $12.31 | $13.68 | |
United
| Professional | $180.30 | $180.30 | $212.61 |
Injection Gonadorelin Hydrochloride Per 100 Mcg (Special Coverage Instructions Apply. See Mcm: 2049)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.98 | $690.98 | $690.98 | |
Aetna
| Professional | $170.09 | $170.09 | $180.72 | |
BCBS
| Facility | $12.31 | $12.31 | $13.68 | |
United
| Professional | $180.30 | $180.30 | $212.61 |