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Indiana rates for HCPCS J9202

Goserelin Acetate Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.00 / $2,004.23 / $5,084.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $741.00 / $880.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.15 / $734.15 / $734.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.67 / $1,467.34 / $1,775.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.66 / $733.67 / $1,012.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.67 / $807.04 / $1,100.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $734.15 / $990.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.67 / $733.67 / $913.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $733.67 / $830.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $777.69 / $980.04