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North Dakota rates for HCPCS Q9992

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,630.78 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,019.95 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $1,995.26 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,995.26 / $2,238.72