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South 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
$56.23 / $56.23 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $83.18 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $57.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $83.18 / $120.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20