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Idaho rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,848.63 / $5,848.63 / $5,848.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,854.35 / $5,848.63
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,456.00 / $5,166.29 / $6,433.49
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,685.58 / $1,700.02 / $4,586.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $3,500.00 / $4,649.66
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,724.77 / $2,999.53 / $10,332.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $4,873.85 / $5,166.29