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North Carolina 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
$106.66 / $119.54 / $142.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.52 / $119.54 / $119.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.50 / $46.50 / $58.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.95 / $106.66 / $119.54
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00