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Indiana rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $109,647.82 / $194,984.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $52,480.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51,286.14 / $64,565.42 / $95,499.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $64,565.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $53,703.18 / $81,283.05
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,668.36 / $44,668.36 / $44,668.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,782.79 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $52,480.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $44,668.36 / $91,201.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $50,118.72