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Arizona rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.67 / $918.21 / $2,189.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $196.03 / $1,764.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $172.29 / $186.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.16 / $527.96 / $935.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.44 / $169.39 / $184.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.47 / $176.45 / $180.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $211.93 / $621.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $155.41 / $2,475.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $187.04