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Maryland rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $56,234.13 / $56,234.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $57,543.99
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45,708.82 / $45,708.82 / $67,608.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $44,668.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36,307.81 / $43,651.58 / $53,703.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $50,118.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $47,863.01 / $51,286.14
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $56,234.13