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Vermont rates for HCPCS J9225

Histrelin implant (Vantas), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $11,942.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $5,579.59
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,971.34 / $4,971.34 / $5,579.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,873.85 / $5,166.29 / $11,279.57