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Wisconsin 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
$7.45 / $7.45 / $16.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.45 / $7.73 / $9.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.91 / $7.91 / $10.00
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.45 / $9.31 / $9.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.45 / $9.31 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $9.94 / $12.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.98 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.45 / $9.31 / $9.31
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.00 / $85.00 / $90.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $4.69 / $11.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.44 / $9.77 / $12.71