go back

Maine 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
$327.10 / $327.10 / $352.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.63 / $169.92 / $169.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.44 / $171.26 / $446.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $140.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.99 / $140.99 / $140.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $140.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $170.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.10 / $327.10 / $352.48
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.63 / $169.92 / $352.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.75 / $140.99 / $204.44