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Michigan rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $87,096.36 / $138,038.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $54,954.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $95,499.26 / $190,546.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41,686.94 / $43,651.58 / $45,708.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $48,977.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $107,151.93 / $138,038.43
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $57,543.99
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $48,977.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $44,668.36 / $45,708.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $53,703.18