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Pennsylvania rates for HCPCS G2086

Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month

Facilitymedian $355 · 10th–90th $309–$4570%20%10th90th$355Professionalmedian $355 · 10th–90th $240–$4570%20%10th90th$355$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $354.81 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $346.74 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $407.38 / $467.74
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,000.00
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $524.81 / $831.76
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $524.81
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $354.81 / $416.87
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $346.74 / $436.52
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $870.96 / $977.24
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $380.19 / $467.74
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $380.19 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $269.15 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $398.11 / $660.69