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West Virginia rates for HCPCS J9226

Histrelin implant (Supprelin LA), 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $52,480.75 / $147,910.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $52,480.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44,668.36 / $44,668.36 / $44,668.36
CareSource
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
$40,738.03 / $67,608.30 / $67,608.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $190,546.07
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 / $47,863.01 / $60,255.96