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Vermont rates for HCPCS J9217

Leuprolide Acetate Suspnsion

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.44 / $178.21 / $2,376.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.75 / $199.75 / $828.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.62 / $187.62 / $187.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $195.04 / $325.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $325.07
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $195.04 / $325.07
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $325.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $187.04 / $529.35