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Alaska rates for HCPCS Q9991

Injection, buprenorphine extended-release (Sublocade), less than or equal to 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,639.63 / $6,517.56 / $12,867.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,240.23 / $3,750.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,363.29 / $5,363.29 / $5,363.29
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $6,492.87
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,915.94 / $3,387.75 / $5,323.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,960.85 / $4,839.64 / $7,985.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,187.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $3,024.63 / $4,067.52