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Texas rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $85,113.80 / $162,181.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $52,480.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,884.42 / $87,096.36 / $158,489.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50,118.72 / $50,118.72 / $50,118.72
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223,872.11 / $223,872.11 / $223,872.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199,526.23 / $199,526.23 / $199,526.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $75,857.76
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $47,863.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41,686.94 / $45,708.82 / $52,480.75
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,183.83 / $32,359.37 / $97,723.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,908.68 / $43,651.58 / $72,443.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $40,738.03 / $54,954.09
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
$43,651.58 / $45,708.82 / $47,863.01
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $53,703.18