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Utah 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
$2,041.74 / $5,888.44 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,398.83 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $1,778.28
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $3,090.30 / $5,754.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,238.72 / $2,238.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,737.80 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $1,949.84