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Minnesota 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
$1,485.00 / $1,485.00 / $1,485.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,188.00 / $1,232.55 / $1,485.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,246.16 / $1,633.85 / $2,797.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,009.80 / $1,262.25 / $1,388.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,473.76 / $4,256.97 / $5,182.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,349.87 / $1,568.16 / $1,697.36
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,133.77 / $3,763.58 / $4,875.55
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,336.50 / $1,336.50 / $1,425.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,558.75 / $6,558.75 / $6,558.75