go back

South Dakota rates for HCPCS G2073

Medication assisted treatment, naltrexone; weekly 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
$1,640.51 / $1,640.51 / $1,640.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,382.76 / $1,604.90 / $2,235.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,977.00 / $2,471.25 / $2,510.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,382.76 / $1,695.36 / $2,772.46