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Idaho rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $50,118.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $66,069.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $47,863.01 / $89,125.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47,863.01 / $47,863.01 / $51,286.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34,673.69 / $45,708.82 / $61,659.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39,810.72 / $45,708.82 / $53,703.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $33,113.11 / $38,904.51
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $66,069.34 / $109,647.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $51,286.14 / $51,286.14
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,018.94 / $40,738.03 / $42,657.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $45,708.82