go back

Utah 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
$2,339.05 / $2,339.05 / $2,593.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,339.05 / $2,339.05 / $2,339.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,259.85 / $2,748.00 / $2,934.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,010.58 / $3,962.35 / $5,688.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,915.60 / $2,016.42 / $2,016.42