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Kentucky 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
$55.37 / $75.31 / $76.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.37 / $76.09 / $95.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.50 / $35.28 / $35.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.97 / $64.26 / $66.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.15 / $56.58 / $80.26