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Illinois 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
$33.88 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $79.43 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $46.77 / $57.54
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $199.53 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $42.66 / $75.86