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Hawaii rates for HCPCS J7298

Levonorgestrel-releasing intrauterine contraceptive system (Mirena), 52 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,101.70 / $1,630.80 / $4,240.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,238.93 / $1,238.93 / $1,238.93
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.63 / $1,214.63 / $1,433.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,136.89 / $1,214.63 / $1,821.95
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,107.70 / $1,107.70 / $1,107.70