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North Carolina rates for HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $741.31 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $467.74 / $933.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $812.83 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $537.03 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $467.74 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $1,096.48
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $436.52 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $776.25 / $870.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $489.78 / $724.44
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $2,398.83