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New Mexico rates for HCPCS J9219

Leuprolide acetate implant, 65 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,578.83 / $4,578.83 / $5,000.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,855.86 / $3,952.25 / $4,578.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $4,819.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $4,819.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.00 / $5,108.99 / $7,663.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,134.73 / $4,783.14 / $5,791.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $4,819.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,684.00 / $5,684.00 / $6,025.04