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Pennsylvania rates for HCPCS J3315

Triptorelin Pamoate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.59 / $1,042.83 / $1,495.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $479.59 / $1,010.30
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$437.88 / $515.15 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.76 / $492.76 / $492.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.96 / $474.84 / $474.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $474.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$872.03 / $872.03 / $990.63
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.58 / $839.63 / $1,495.38
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $496.82 / $1,495.38
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.96 / $474.84 / $474.84
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $474.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$374.55 / $374.55 / $434.62
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.55 / $374.55 / $434.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $503.33 / $868.96