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Michigan 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
$68.00 / $78.00 / $92.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.98 / $1.98 / $78.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $1,500.00