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California rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,854.35 / $11,441.70 / $27,250.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,854.35 / $11,469.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $8,595.67 / $19,293.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $9,612.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.09 / $100.00 / $6,433.49
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,263.77 / $5,263.77 / $11,728.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,166.29 / $6,199.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$801.00 / $5,136.00 / $12,071.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,060.60 / $24,957.02 / $25,866.89
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24,212.69 / $24,212.69 / $39,884.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $11,226.29 / $11,226.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,032.00 / $5,166.29 / $7,304.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $6,092.33
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,113.47 / $8,113.47 / $8,113.47
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $6,716.18 / $7,749.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,044.07 / $13,746.97 / $13,746.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $4,873.85 / $8,700.95