go back

Nebraska rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.14 / $288.66 / $331.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.14 / $120.14 / $201.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.86 / $71.81 / $71.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.20 / $71.09 / $71.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $65.25 / $81.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.38 / $228.27 / $663.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.64 / $125.15 / $150.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.03 / $76.18 / $153.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.03 / $99.63 / $159.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.89 / $125.15 / $137.66