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Tennessee rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.34 / $264.67 / $6,254.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.44 / $178.21 / $1,723.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $155.41 / $176.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.41 / $172.29 / $195.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.45 / $176.45 / $180.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.03 / $1,272.84 / $1,413.42
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,475.46 / $2,475.46 / $2,475.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.63 / $176.45 / $208.21