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Alabama rates for HCPCS J1950

Injection Leuprolide Acetate (For Depot Suspension) Per 3.75 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,730.31 / $2,335.92 / $5,867.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.31 / $1,747.63 / $1,922.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.22 / $1,133.72 / $1,525.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,791.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,730.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,894.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,770.52 / $1,770.52 / $1,770.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,834.14