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Wisconsin 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

Facilitymedian $81 · 10th–90th $46–$2340%20%10th90th$81Professionalmedian $83 · 10th–90th $74–$1120%20%10th90th$83$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $83.18 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $177.83 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $151.36 / $173.78
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $79.43 / $95.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $75.86 / $120.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $50.12 / $58.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $125.89