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North Carolina rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $6,699.02 / $9,970.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,971.34 / $5,848.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,816.98 / $7,806.50 / $13,103.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.60 / $3,956.30 / $3,956.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $5,244.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $5,848.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,462.69 / $4,980.00 / $6,600.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,462.69 / $6,059.00 / $6,507.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,557.60 / $9,557.60 / $9,557.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,166.29 / $5,848.63
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,060.60 / $25,866.89 / $25,866.89
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24,212.69 / $39,884.69 / $39,884.69