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Tennessee 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
$176.47 / $229.41 / $349.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.09 / $176.47 / $176.47
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.71 / $212.61 / $212.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $180.72