go back

Oregon rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.96 / $352.90 / $3,052.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $522.87 / $1,900.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $307.01 / $344.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $206.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.30 / $369.16 / $475.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $237.84 / $596.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $191.64 / $241.74
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $199.75 / $529.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.45 / $213.50 / $591.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $211.81 / $244.07
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.45 / $288.86 / $605.77
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $194.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $204.68