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Hawaii rates for HCPCS Q9992

Injection, buprenorphine extended-release (Sublocade), greater than 100 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,570.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,398.83 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,344.23 / $3,019.95