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Idaho rates for HCPCS G2215

Take home supply of nasal naloxone; 2-pack of 4 mg per 0.1 ml nasal spray (provision of the services by a Medicare-enrolled Opioid Treatment Program); list separately in addition to code for primary procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.11 / $40.11 / $40.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.11 / $92.04 / $94.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.12 / $92.04 / $95.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.00 / $1,500.00 / $1,500.00