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Montana rates for HCPCS J1951

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.83 / $169.92 / $169.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.26 / $153.26 / $153.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $153.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.26 / $153.26 / $153.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $152.96 / $199.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $140.99