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New Mexico rates for HCPCS J9202

Goserelin acetate implant, per 3.6 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,202.26 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,096.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,445.44 / $2,398.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $870.96 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $776.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $741.31 / $1,047.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $776.25 / $1,288.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,202.26 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,202.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $776.25 / $831.76