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Vermont rates for HCPCS J9219

Leuprolide Acetate Implant 65 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,096.85 / $4,096.85 / $4,096.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $5,301.86
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $5,301.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,399.80 / $6,025.04 / $13,154.48