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Pennsylvania rates for HCPCS J3316

Injection Triptorelin Extended-Release 3.75 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,817.28 / $7,998.44 / $11,469.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,855.45 / $4,839.43
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,520.18 / $4,141.39 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,961.33 / $3,961.33 / $3,961.33
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
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,810.58 / $6,439.88 / $11,469.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,810.58 / $3,855.45 / $11,469.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,601.20 / $3,817.28 / $3,817.28
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $3,817.28 / $3,817.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,817.28 / $4,046.32 / $5,393.97