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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
$2,089.30 / $2,089.30 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,819.70 / $2,238.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,778.28 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,290.87
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93