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Massachusetts rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $6,746.11 / $9,814.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,971.34 / $4,971.34
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,166.29 / $7,961.30 / $25,866.89
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,166.29 / $24,212.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,538.26 / $6,344.20 / $12,326.77
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,166.29 / $5,979.46
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,060.60 / $25,866.89 / $25,866.89
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,166.29 / $24,212.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,166.29 / $5,997.87