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Connecticut 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
$1,799.54 / $2,769.85 / $7,497.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,799.54 / $1,799.54 / $1,799.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,542.23 / $2,630.43 / $5,186.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,730.32
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 / $1,730.32
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,795.62 / $1,795.62 / $2,164.54
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,111.40 / $6,111.40 / $6,111.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,557.29 / $1,828.95 / $1,982.14