go back

Massachusetts rates for HCPCS J0570

Buprenorphine Implant 74.2 Mg (Special Coverage Instructions Apply. See Mcm: 2049) (Reinstated 01/01/2017). Injection Penicillin G Benzathine Up To 1 200 000 Units (Special Coverage Instructions Apply. See Mcm: 2049) (Del 12/31/2010)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,262.25 / $1,262.25 / $2,598.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,262.25 / $1,262.25 / $1,262.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,280.52 / $1,485.00 / $6,558.75
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.52 / $1,311.75 / $1,377.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,262.25 / $1,336.50 / $1,670.63
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.00 / $6,558.75 / $6,558.75