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Idaho rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $926.64 / $9,128.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $529.53 / $1,673.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $166.46 / $176.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $232.88 / $443.88
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $187.03 / $228.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.30 / $172.29 / $335.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.57 / $270.81 / $451.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.74 / $211.74 / $220.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $196.43