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Montana rates for HCPCS J7307

Etonogestrel (contraceptive) implant system, including implant and supplies

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.80 / $1,214.63 / $1,650.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,746.68 / $77,999.99 / $94,999.99
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
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$744.10 / $1,238.93 / $1,457.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,160.00 / $1,238.93 / $1,387.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.63 / $1,214.63 / $1,214.63