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Maryland rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,971.34 / $7,407.30
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,166.29 / $5,166.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,244.99 / $5,244.99 / $5,244.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,391.35 / $5,708.37 / $7,374.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,425.63 / $5,897.37
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,166.29 / $5,166.29