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Oklahoma rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $302.00 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $194.98 / $1,778.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $234.42 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $181.97 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
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 / $169.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $190.55 / $467.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $173.78 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $169.82 / $177.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $173.78 / $190.55