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North Dakota rates for HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.84 / $474.84 / $885.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.83 / $479.58 / $595.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.15 / $517.73 / $524.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$437.88 / $516.95 / $521.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.53 / $480.53 / $600.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.39 / $491.90 / $925.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.90 / $547.59 / $594.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $528.60 / $574.09