go back

Nebraska rates for HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.90 / $736.92 / $1,049.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $601.08 / $1,010.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.17 / $510.68 / $537.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.68 / $532.16 / $556.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $480.53 / $600.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.90 / $823.36 / $2,358.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.63 / $491.90 / $585.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.83 / $682.42 / $962.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.22 / $545.00 / $821.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $528.60 / $565.05