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Kansas 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
$77.67 / $77.67 / $77.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.67 / $79.34 / $91.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.25 / $163.16 / $167.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.50 / $46.50 / $58.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.39 / $79.34 / $95.25