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Wisconsin rates for HCPCS J0571

Buprenorphine/Naloxone Oral Less Than Or Equal To 3 Mg Buprenorphine (Revised 01/01/2016)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.32 / $0.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.32 / $0.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.32 / $0.32
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.41