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Wisconsin rates for HCPCS G2069

Medication Assisted Treatment Buprenorphine (Injectable); Weekly Bundle Including Dispensing And/Or Administration Substance Use Counseling Individual And Group Therapy And Toxicology Testing If Performed (Provision Of The Services Bya Medicare-Enrolled Opioid Treatment Program)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,001.32 / $2,001.32 / $2,001.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,799.52 / $1,951.68 / $2,214.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.31 / $1,747.11 / $1,817.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,509.45 / $6,438.23 / $9,876.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,349.75 / $3,490.07 / $3,965.99
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,803.02 / $2,017.02 / $2,811.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,802.10 / $2,006.39 / $2,811.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $87.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,803.02 / $2,018.05 / $2,811.42
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,020.53 / $2,020.53 / $2,020.53