go back

Missouri rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,128.61 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $4,897.79 / $5,888.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,011.87 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,011.87 / $5,011.87 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,495.41 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $5,128.61 / $23,988.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,585.78 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $4,897.79 / $5,495.41