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Pennsylvania 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
Facility
Modifier
Low / Median / High Price
$7.91 / $18.51 / $21.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.91 / $7.91 / $7.91
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.35 / $8.65 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.65 / $8.65 / $8.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.24 / $8.76 / $10.30
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $4.16 / $22.75
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.91 / $14.63 / $20.67
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.91 / $7.91 / $18.11
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $4.62 / $5.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.91 / $9.77 / $11.74