go back

Nebraska 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
$2,016.42 / $3,875.76 / $4,457.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $6,049.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,712.09 / $2,168.65 / $2,282.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,125.78 / $2,215.28 / $2,282.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.55 / $2,016.42 / $2,451.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,887.11 / $1,976.55 / $9,626.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,925.23 / $1,976.55 / $2,174.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,192.80 / $2,897.72 / $4,539.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,009.76 / $2,371.86 / $4,264.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,915.60 / $2,016.42 / $2,218.06