go back

Utah rates for HCPCS J3316

Injection, triptorelin, extended-release, 3.75 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $5,011.87 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,801.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $6,309.57 / $11,748.98
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,890.45 / $3,890.45
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,467.37 / $3,801.89 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $4,168.69