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Oregon rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,848.63 / $11,697.30 / $11,697.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,854.35 / $8,339.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,942.68 / $9,942.68 / $9,942.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $4,971.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,553.76 / $10,303.39 / $13,060.81
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,608.00 / $5,166.29 / $10,436.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,685.57 / $1,782.39 / $5,166.29
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,755.00 / $9,314.74 / $9,447.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,608.00 / $5,166.29 / $9,747.71
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $6,092.33 / $6,579.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,449.53 / $7,749.44 / $16,471.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $4,873.85 / $5,604.94