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Montana rates for HCPCS J0574

Buprenorphine/Naloxone Oral Greater Than 6 Mg But Less Than Or Equal To 10 Mg Buprenorphine (Revised 01/01/2016)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.73 / $7.73 / $7.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.91 / $9.31 / $9.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.88 / $2.88 / $2.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.17 / $5.87 / $5.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $9.77