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South Carolina rates for HCPCS J9226

Histrelin Implant (Suprelin La) 50 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35,238.80 / $47,271.68 / $193,411.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,541.00 / $45,470.86 / $47,838.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,918.88 / $42,905.28 / $59,417.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,020.65 / $57,207.04 / $66,932.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42,472.31 / $45,020.65 / $50,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,020.65 / $45,020.65 / $46,719.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,154.46 / $43,467.03 / $74,046.94
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,625.00 / $16,625.00 / $76,024.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47,271.68 / $47,838.40 / $113,030.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,267.55 / $47,721.89 / $49,522.72