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Alaska rates for HCPCS J1950

Injection, leuprolide acetate (for depot suspension), per 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,692.02 / $3,281.97 / $4,023.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.31 / $1,922.39 / $3,530.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,730.32
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,602.31 / $4,602.31 / $4,602.31
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $5,571.63
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,515.89 / $2,881.77 / $4,528.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,526.69 / $4,116.82 / $6,792.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,877.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.21 / $2,595.48 / $5,190.96