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Wisconsin rates for HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

Facilitymedian $692 · 10th–90th $479–$1,3800%20%10th90th$692Professionalmedian $468 · 10th–90th $468–$8320%50%90th$468$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $478.63 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $588.84 / $851.14
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $478.63 / $630.96
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $954.99 / $954.99
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $489.78 / $630.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $549.54 / $954.99
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $467.74
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $436.52 / $436.52
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $630.96 / $1,412.54
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $2,398.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $630.96 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $512.86 / $676.08