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Wyoming rates for HCPCS J9217

Leuprolide acetate (for depot suspension), 7.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,059.77 / $3,911.66 / $4,896.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $178.21 / $242.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.73 / $542.03 / $542.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.46 / $166.46 / $166.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $216.40 / $249.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.45 / $176.45 / $176.45