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Idaho 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
$1,737.10 / $4,577.42 / $8,437.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.31 / $1,886.05 / $2,162.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,632.38 / $1,632.38 / $1,730.32
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
$499.58 / $2,162.91 / $3,092.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $2,162.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,670.30 / $1,670.30 / $1,670.30
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,673.93 / $2,510.90 / $4,184.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,076.39 / $2,076.39 / $2,162.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $1,834.14