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Tennessee rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.65 / $162.05 / $246.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.14 / $124.65 / $124.65
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.18 / $663.30 / $663.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.15 / $125.15 / $127.65