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New Hampshire 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
$33.88 / $79.43 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $79.43 / $97.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49