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New Mexico rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $67,608.30 / $125,892.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $58,884.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52,480.75 / $109,647.82 / $177,827.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $50,118.72 / $67,608.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $44,668.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,708.82 / $47,863.01 / $67,608.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,782.79 / $43,651.58 / $67,608.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $40,738.03 / $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 / $43,651.58 / $45,708.82