go back

Utah 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 / $176.47 / $176.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.47 / $176.47 / $176.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.29 / $180.30 / $180.30