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Nebraska rates for HCPCS J9219

Leuprolide acetate implant, 65 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,855.86 / $9,264.18 / $10,653.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,855.86 / $3,855.86 / $4,819.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,638.04 / $5,456.52 / $5,456.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,183.68 / $5,456.52 / $5,456.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $5,001.70 / $6,252.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,855.86 / $5,684.00 / $7,326.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,684.00 / $5,684.00 / $6,763.96
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $586.13 / $8,013.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.80 / $6,607.92 / $8,013.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,567.60 / $11,567.60 / $11,567.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,684.00 / $5,684.00 / $6,763.96