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Oklahoma rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,737.39 / $4,737.39 / $6,679.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,795.88 / $5,211.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,085.61 / $4,737.39 / $5,848.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,391.35 / $5,166.29 / $24,212.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,630.17 / $4,873.85 / $5,458.72