go back

Michigan rates for HCPCS Q9992

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,035.85 / $2,076.92 / $6,351.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,076.92 / $2,391.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,406.39 / $4,490.43 / $8,494.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,497.53 / $1,761.81 / $2,054.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,736.50 / $2,016.42 / $2,016.42
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,016.42 / $2,544.81 / $5,664.75
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,035.85 / $2,419.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,214.01 / $2,273.03 / $2,318.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,016.42 / $2,016.42 / $2,139.42