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Idaho 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
$1,976.55 / $1,976.55 / $2,273.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,976.55 / $2,036.58 / $2,520.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.29 / $2,016.42 / $2,016.42
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
$2,218.07 / $2,671.76 / $3,604.36
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,218.06 / $2,520.53
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,059.64 / $2,942.34 / $4,904.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,419.71 / $2,419.71 / $2,520.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42