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Rhode Island rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.46 / $4,007.27 / $15,127.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $183.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $155.41 / $460.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $186.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $196.43