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Wisconsin rates for HCPCS G2074

Medication Assisted Treatment Weekly Bundle Not Including The Drug Including 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
$193.51 / $193.51 / $193.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.06 / $192.62 / $229.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.31 / $152.49 / $161.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$558.69 / $652.88 / $1,001.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.75 / $309.56 / $409.68
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.06 / $196.83 / $279.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.06 / $196.83 / $279.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $354.80
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.06 / $199.21 / $279.02
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.46 / $204.46 / $204.46
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.05 / $45.05 / $45.05