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Utah rates for HCPCS J2545

Pentamidine isethionate, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per 300 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $93.33 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $93.33 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $95.50 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $95.50 / $95.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $75.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $69.18 / $83.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.08 / $39.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $89.13 / $89.13