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Maryland rates for HCPCS J7298

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$955.62 / $1,890.36 / $2,709.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,049.24 / $1,176.61 / $1,598.85
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,238.93 / $1,238.93 / $1,238.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,238.93 / $1,238.93 / $1,238.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,311.80 / $1,311.80 / $1,311.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.75 / $1,214.63 / $1,457.56
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,156.79 / $1,156.79 / $1,156.79