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Maine rates for HCPCS Q9992

Injection Buprenorphine Extended-Release (Sublocade) Greater Than 100 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,678.09 / $4,678.09 / $5,041.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,097.08 / $2,391.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,951.29 / $2,449.35 / $6,390.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,016.42
Cigna
Facility/Professional
Facility
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,441.88
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,678.09 / $4,678.09 / $5,041.05
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,036.58 / $2,097.08 / $4,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $3,024.63