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North Carolina rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.44 / $1,278.65 / $9,683.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.56 / $216.70 / $1,683.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $155.41 / $155.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.82 / $279.75 / $375.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.82 / $175.80 / $279.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $176.45 / $361.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $437.32
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.45 / $335.50 / $625.79
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.52 / $262.00 / $514.34
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.83 / $286.52 / $371.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $187.04 / $220.56
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.03 / $1,272.84 / $1,413.42
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,475.46 / $2,475.46 / $2,475.46