go back

West Virginia rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.65 / $127.65 / $129.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.65 / $127.65 / $127.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.69 / $52.69 / $92.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.43 / $63.43 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.43 / $63.43 / $285.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.40 / $125.15 / $150.18