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Montana rates for HCPCS J7298

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,344.23 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,380.38 / $2,691.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $64,565.42 / $95,499.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $79.43 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,258.93 / $1,258.93