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West Virginia 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
$180.72 / $180.72 / $180.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.47 / $180.72 / $180.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,999.55 / $59,999.40 / $69,999.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35,999.64 / $35,999.64 / $41,999.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.35 / $191.35 / $191.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.30 / $180.30 / $212.61