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Maryland 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 / $580.54 / $2,058.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $183.50 / $2,312.38
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $155.41 / $176.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.79 / $180.79 / $460.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $222.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.97 / $176.45 / $1,373.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $196.43 / $215.27
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.79 / $180.79 / $231.15