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Ohio rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,678.89 / $12,691.50 / $16,668.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,772.47 / $6,236.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $7,749.44 / $12,915.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,779.52 / $8,322.89
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,583.64 / $4,591.21 / $6,232.41
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $5,848.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,941.23 / $7,450.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $4,873.85 / $5,848.63