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Louisiana rates for HCPCS J2315

Injection Naltrexone Depot Form 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.24 / $4.37 / $9.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.28 / $5.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.30 / $4.30 / $6.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.30 / $4.30 / $4.38
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $5.27