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West Virginia rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.03 / $4,130.30 / $4,130.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $242.31
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.41 / $176.45 / $264.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $200.76 / $409.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $460.73 / $460.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $206.75
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.79 / $1,047.63 / $1,466.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $195.86 / $1,526.08