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Nebraska rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $66,069.34 / $87,096.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $72,443.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39,810.72 / $46,773.51 / $60,255.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46,773.51 / $47,863.01 / $48,977.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $52,480.75 / $69,183.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $52,480.75 / $87,096.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,708.82 / $51,286.14 / $199,526.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53,703.18 / $67,608.30 / $69,183.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,480.75 / $67,608.30 / $114,815.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $43,651.58 / $91,201.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $53,703.18