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Michigan rates for HCPCS J9202

Goserelin acetate implant, per 3.6 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,000.00 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,698.24 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $562.34 / $588.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $870.96 / $1,174.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $831.76
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $933.25 / $2,511.89
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $794.33 / $1,096.48
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $741.31 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $831.76 / $954.99