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Oklahoma 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
$1,202.84 / $1,202.84 / $1,202.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.84 / $1,202.84 / $1,232.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.32 / $0.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,262.25 / $1,262.25 / $1,670.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.00 / $6,558.75 / $6,558.75