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Illinois rates for HCPCS J9218

Leuprolide Acetate Per 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.47 / $70.38 / $184.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $48.54 / $51.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.94 / $85.34 / $269.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.83 / $14.49 / $14.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.42 / $51.42 / $51.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.42 / $51.42 / $51.42
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $28.32 / $494.16
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.58 / $11.58 / $11.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $12.47 / $13.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.40 / $53.42 / $63.00