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Virginia rates for HCPCS J7298

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,101.70 / $2,065.56 / $3,733.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.63 / $1,214.63 / $2,064.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,166.05 / $1,166.05 / $1,166.05
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
$1,238.93 / $1,238.93 / $1,238.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,457.56 / $1,457.56 / $1,457.56
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,457.56 / $1,457.56 / $1,849.88
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.90 / $1,214.63 / $1,554.73
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,153.90 / $1,214.63 / $1,554.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.01 / $1,214.63 / $1,457.56