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Vermont rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123,026.88 / $123,026.88 / $123,026.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $50,118.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51,286.14 / $51,286.14 / $51,286.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $51,286.14 / $51,286.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $51,286.14
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,620.87 / $48,977.88 / $48,977.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40,738.03 / $45,708.82 / $51,286.14