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Utah rates for HCPCS J9202

Goserelin acetate implant, per 3.6 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.05 / $2,229.08 / $2,844.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $755.67 / $1,545.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$822.44 / $928.56 / $1,067.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $733.67 / $733.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.56 / $734.15 / $951.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$962.91 / $1,332.25 / $1,912.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.04 / $994.43 / $1,046.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.67 / $733.67 / $733.67