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Indiana rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $120.14 / $540.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.14 / $120.14 / $120.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $63.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $63.43 / $125.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.58 / $54.58 / $60.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.58 / $54.58 / $68.23
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 / $174.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.15 / $125.15 / $155.19