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New Mexico rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,556.20 / $5,556.20 / $6,067.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,854.35 / $5,848.63
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 / $4,971.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.00 / $5,476.24 / $8,214.36
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,728.91 / $4,678.89 / $5,848.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $6,092.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $4,873.85 / $5,166.29