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Oklahoma rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $46,773.51 / $79,432.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $52,480.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $40,738.03 / $43,651.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37,153.52 / $48,977.88 / $74,131.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $45,708.82 / $199,526.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $44,668.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41,686.94 / $45,708.82 / $50,118.72