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Missouri 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 / $562.34 / $3,090.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $288.40 / $1,905.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $181.97 / $478.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $177.83 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $194.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $218.78 / $537.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $165.96 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $208.93 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $173.78 / $204.17