go back

Arizona rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52,480.75 / $75,857.76 / $151,356.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $57,543.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39,810.72 / $95,499.26 / $186,208.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36,307.81 / $47,863.01 / $75,857.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,840.32 / $50,118.72 / $77,624.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,708.82 / $45,708.82 / $199,526.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $44,668.36 / $74,131.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $47,863.01