go back

Virginia rates for HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.58 / $1,032.98 / $2,940.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.83 / $498.58 / $845.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.84 / $1,001.91 / $1,614.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $474.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.21 / $713.72 / $1,077.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.96 / $447.96 / $474.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $474.84 / $474.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.61 / $569.80 / $1,036.23
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.96 / $624.44 / $925.12
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.00 / $203.00 / $203.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.10 / $574.55 / $975.89
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.10 / $574.55 / $975.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $503.33 / $617.29