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West Virginia 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
$1,747.63 / $1,922.39 / $7,352.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.31 / $1,747.63 / $1,922.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,730.32 / $1,737.10 / $2,595.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,011.83 / $4,011.83 / $4,011.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,632.38 / $1,730.32 / $1,837.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,730.32 / $3,158.36
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,900.68 / $3,900.68 / $3,900.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,866.22 / $2,866.22 / $2,866.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,730.32 / $1,834.14 / $2,154.50