go back

Utah 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
$162.88 / $163.55 / $163.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.55 / $163.55 / $163.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.66 / $191.64 / $207.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.99 / $140.99 / $140.99
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.18 / $282.80 / $406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.94 / $140.99 / $156.94