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Illinois rates for HCPCS J7604

Acetylcysteine, inhalation solution, compounded product, administered through DME, unit dose form, per g

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $83.18
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $61.66 / $79.43
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.17 / $1.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $0.98 / $0.98