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Rhode Island rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85,113.80 / $85,113.80 / $85,113.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $60,255.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $45,708.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $43,651.58 / $43,651.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
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 / $47,863.01