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Idaho rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.18 / $150.18 / $150.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.14 / $127.65 / $150.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.43 / $63.43 / $63.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $63.43 / $63.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.65 / $136.90 / $184.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.81 / $62.11 / $62.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.15 / $91.83 / $136.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.15 / $125.15 / $125.15