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Illinois rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $66,069.34 / $87,096.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $60,255.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,902.95 / $75,857.76 / $407,380.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,480.75 / $52,480.75 / $58,884.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $56,234.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,018.94 / $56,234.13 / $69,183.10
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58,884.37 / $58,884.37 / $58,884.37
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46,773.51 / $56,234.13 / $60,255.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $44,668.36 / $74,131.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $50,118.72