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Virginia rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,971.34 / $5,428.70 / $10,738.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,678.89 / $4,971.34 / $4,971.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,166.29 / $10,694.22 / $16,893.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $6,675.51
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,166.29 / $5,166.29 / $5,166.29
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,349.22 / $5,436.54 / $9,024.66
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,363.33 / $5,102.34 / $7,895.65
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,868.15 / $6,283.00 / $8,278.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,166.29 / $5,756.05