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Connecticut rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.45 / $247.83 / $564.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $183.50 / $1,734.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.69 / $294.04 / $684.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.11 / $191.43 / $264.87
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.65 / $626.65 / $666.90
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.74 / $1,173.35 / $1,478.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.63 / $176.45 / $196.43