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Washington rates for HCPCS J9219

Leuprolide acetate implant, 65 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,096.85 / $4,096.85 / $9,639.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,855.86 / $4,096.85 / $4,096.85
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,301.80 / $5,301.80 / $5,301.80
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,717.72 / $6,584.84 / $21,887.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $9,639.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $5,911.10
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,541.59 / $4,819.82 / $9,821.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $8,916.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $5,252.01 / $5,729.47
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $4,819.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $5,301.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,684.00 / $5,684.00 / $6,820.80
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.82 / $4,819.82 / $4,819.82