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Washington rates for HCPCS J2315

Injection Naltrexone Depot Form 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.66 / $2,949.79 / $5,509.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.66 / $6.54
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.96 / $6.15 / $11.89
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.36 / $5.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.00 / $9.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $4.24 / $5.20
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.24 / $5.30 / $12.72
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.52 / $6.33 / $11.09
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.47 / $5.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.94 / $4.92 / $9.13
Regence BlueShield
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 / $4.24