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Rhode Island 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
$196.59 / $196.59 / $196.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $51.42 / $51.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.42 / $53.42 / $56.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.44 / $54.44 / $54.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.42 / $51.42 / $51.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.75 / $51.42 / $51.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.40 / $50.40 / $56.11