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Michigan rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,678.89 / $5,848.63 / $8,188.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,678.89 / $4,971.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,002.41 / $11,269.39 / $21,473.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,001.13 / $5,474.92 / $7,106.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $5,842.78
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,678.89 / $6,082.57 / $13,019.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $5,166.29 / $6,199.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,682.91 / $7,749.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,425.63 / $5,897.37