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North Dakota rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $173.78 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $173.78 / $1,258.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $186.21 / $186.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $186.21 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $173.78 / $218.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $169.82 / $407.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $173.78 / $380.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $169.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $173.78 / $204.17