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Nebraska rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,678.89 / $10,202.29 / $12,927.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,678.89 / $7,852.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.45 / $5,848.76 / $5,848.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,556.31 / $5,848.76 / $5,848.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $6,350.60 / $6,841.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,133.46 / $6,784.41 / $8,889.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,425.63 / $24,212.69
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.36 / $6,273.47 / $8,524.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,142.80 / $6,273.47 / $8,524.37
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,414.60 / $6,414.60 / $7,653.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $4,873.85 / $5,799.89