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South Carolina rates for HCPCS J9217

Leuprolide Acetate Suspnsion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.29 / $2,029.70 / $23,368.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.44 / $185.27 / $807.53
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $155.41 / $444.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.95 / $589.91 / $1,072.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $353.12 / $611.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $176.45 / $253.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $186.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.45 / $333.38 / $685.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.17 / $447.00 / $685.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.19 / $185.27 / $430.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.97 / $187.04 / $220.56