go back

Maine rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41,686.94 / $107,151.93 / $107,151.93
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
$41,686.94 / $50,118.72 / $138,038.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $44,668.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $67,608.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $40,738.03 / $43,651.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41,686.94 / $100,000.00 / $107,151.93
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $44,668.36 / $69,183.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $43,651.58 / $52,480.75