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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
$173.78 / $338.84 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $173.78 / $1,047.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $190.55 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $724.44 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $177.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $173.78 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $169.82 / $199.53