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North Carolina rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $51,286.14 / $91,201.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $60,255.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36,307.81 / $63,095.73 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32,359.37 / $45,708.82 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $60,255.96
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,791.08 / $14,791.08 / $14,791.08
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,877.62 / $44,668.36 / $66,069.34
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $58,884.37 / $81,283.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $74,131.02 / $83,176.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $47,863.01
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223,872.11 / $223,872.11 / $223,872.11
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199,526.23 / $199,526.23 / $199,526.23