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Pennsylvania rates for HCPCS J9155

Injection, degarelix, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.40 / $7.61 / $13.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.49 / $480.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.12 / $4.83 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $4.62 / $4.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.20 / $4.45 / $4.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.62
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $4.83 / $6.23
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.40 / $9.50 / $1,451.52
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.40 / $4.71 / $341.60
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.59 / $5.92 / $27.40
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.20 / $4.45 / $4.45
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.12 / $4.12 / $4.79
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $4.12 / $4.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.72 / $6.34