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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
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $77.62 / $95.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $35.48 / $35.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $51.29 / $64.57
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57