go back

Alaska rates for HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.94 / $905.78 / $3,202.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.83 / $527.54 / $1,010.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $474.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,262.98 / $1,262.98 / $1,262.98
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $1,528.98
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$726.48 / $1,448.22 / $2,275.77
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$692.10 / $1,448.22 / $3,413.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $515.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.60 / $712.26 / $1,424.52