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Pennsylvania rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $74,131.02 / $131,825.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $60,255.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39,810.72 / $46,773.51 / $58,884.37
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44,668.36 / $44,668.36 / $44,668.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $44,668.36
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $60,255.96 / $60,255.96
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,791.08 / $43,651.58 / $74,131.02
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51,286.14 / $51,286.14 / $51,286.14
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $74,131.02 / $131,825.67
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $74,131.02
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81,283.05 / $81,283.05 / $81,283.05
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $30,902.95 / $97,723.72
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $50,118.72 / $52,480.75
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $50,118.72 / $52,480.75
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 / $45,708.82 / $53,703.18