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Massachusetts rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $75,857.76 / $173,780.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $66,069.34
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $114,815.36 / $223,872.11
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $43,651.58 / $199,526.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $85,113.80
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 / $43,651.58
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $43,651.58 / $70,794.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $40,738.03 / $47,863.01
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75,857.76 / $75,857.76 / $75,857.76
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,668.36 / $44,668.36 / $44,668.36
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $114,815.36 / $223,872.11
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $43,651.58 / $199,526.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $97,723.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $51,286.14