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Louisiana rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,848.63 / $6,141.06 / $13,802.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,737.39 / $5,848.63 / $5,848.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,176.44 / $4,766.63 / $5,982.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,766.63 / $4,766.63 / $4,861.96
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,386.47 / $4,873.85 / $5,609.81