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Pennsylvania rates for HCPCS J0572

Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $6.40 / $9.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.36 / $5.13 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $5.13 / $5.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.61 / $4.90 / $5.76
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.18 / $9.18 / $12.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $6.40 / $9.92
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $9.16
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $6.36 / $7.63