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North Dakota rates for HCPCS J9202

Goserelin acetate implant, per 3.6 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $3,630.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $851.14 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $794.33 / $1,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $741.31 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $812.83 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $933.25