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Maine rates for HCPCS J3316

Injection, triptorelin, extended-release, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,856.09 / $8,856.09 / $9,543.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,969.97 / $4,565.14 / $4,565.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,693.98 / $4,636.85 / $12,096.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $3,817.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $3,817.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $3,817.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $4,622.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,856.09 / $8,856.09 / $9,543.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,969.96 / $4,565.14 / $9,543.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $5,725.92