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New Hampshire rates for HCPCS J3316

Injection Triptorelin Extended-Release 3.75 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,772.85 / $4,225.59 / $7,545.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $3,817.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,549.82 / $6,871.10 / $17,316.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,772.85 / $3,817.28 / $3,817.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,601.20 / $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
$4,005.09 / $6,199.26 / $11,782.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $4,046.32
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,002.37 / $3,401.68 / $4,203.32