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Maryland rates for HCPCS J1951

Injection, leuprolide acetate for depot suspension (Fensolvi), 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.43 / $140.43 / $140.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $188.18
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.43 / $140.43 / $140.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $179.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $165.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $156.94 / $207.54
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.47 / $136.47 / $136.47