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Louisiana rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.08 / $235.46 / $3,156.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.44 / $178.21 / $588.05
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $220.53 / $288.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.52 / $250.32 / $284.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.52 / $189.52 / $193.31
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$708.92 / $708.92 / $708.92
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.33 / $176.45 / $220.21