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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
$8,709.64 / $9,332.54 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $4,570.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $4,365.16 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,801.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,801.89 / $4,466.84
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $8,709.64 / $9,332.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,890.45 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,801.89 / $5,495.41