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New Hampshire rates for HCPCS J9202

Goserelin acetate implant, per 3.6 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.66 / $880.98 / $2,284.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.66 / $733.67 / $822.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$865.14 / $1,144.53 / $3,019.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $733.67 / $734.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$692.14 / $733.67 / $733.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $733.67 / $733.67
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $733.67 / $1,229.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.59 / $733.67 / $777.69
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.32 / $253.58 / $372.77