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Utah 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
$50.21 / $50.21 / $50.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $50.21 / $60.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.43 / $11.77 / $20.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.42 / $51.42 / $51.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $12.02 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.79 / $9.39 / $13.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.79 / $40.40 / $42.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.40 / $50.40 / $50.40