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Missouri 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
$79.34 / $79.36 / $79.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.45 / $79.34 / $80.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.77 / $19.89 / $35.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.97 / $46.97 / $46.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.13 / $79.36 / $144.38