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Hawaii rates for HCPCS Q9991

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,820.44 / $2,820.44 / $2,820.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,218.07 / $2,419.71 / $2,822.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,318.17 / $3,024.63