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Wisconsin rates for HCPCS J9155

Degarelix Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.58 / $8.72 / $10.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.58 / $7.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.56 / $8.23 / $9.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $6.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.12 / $8.01 / $8.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.45 / $6.38 / $11.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $5.53 / $8.23
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.05 / $4.45 / $6.33
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.54 / $8.90 / $8.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.05 / $4.36 / $5.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.36 / $4.84 / $1,033.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.97 / $4.45 / $5.80
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.54 / $8.90 / $8.90
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $6.75 / $13.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.45 / $4.45 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $7.88 / $1,033.47
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $6.25 / $6.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.72 / $5.30