go back

Pennsylvania 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
$1,803.93 / $1,820.86 / $1,932.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,768.01 / $1,820.86 / $2,086.44
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,695.16 / $1,994.31 / $1,994.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,373.25 / $2,490.73 / $2,984.18
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,803.93 / $1,820.86 / $1,932.70
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,753.90 / $1,816.09 / $2,036.46
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,505.50 / $3,505.50 / $3,505.50
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,373.25 / $2,490.73 / $2,984.18
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,751.39 / $1,751.39 / $1,751.39