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North Dakota rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $125,892.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $53,703.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $46,773.51 / $47,863.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35,481.34 / $46,773.51 / $52,480.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $56,234.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,703.96 / $45,708.82 / $81,283.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,708.82 / $51,286.14 / $56,234.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $44,668.36 / $52,480.75