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Montana rates for HCPCS J9155

Degarelix Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.84 / $375.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.66 / $68,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.34 / $5.34 / $11.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $5.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.65 / $5.16 / $6.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $5.16 / $5.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45