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New Hampshire rates for HCPCS G2069

Medication assisted treatment, buprenorphine (injectable) administered on a monthly basis; bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a Medicare-enrolled opioid treatment program)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,754.43 / $2,034.12 / $2,034.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,754.43 / $1,816.09 / $2,176.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,493.69 / $1,757.30 / $1,828.10
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,259.69 / $1,385.66 / $1,763.57