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Indiana rates for HCPCS J7298

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,143.83 / $1,849.90 / $2,776.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.75 / $1,214.63 / $1,763.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,147.83 / $2,429.26 / $3,643.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.72 / $1,164.66 / $1,416.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.74 / $1,721.74 / $2,168.11
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,721.74 / $1,721.74 / $1,980.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,238.93 / $1,238.93 / $1,238.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,070.23 / $1,238.93 / $3,244.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.63 / $1,214.63 / $1,506.14