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Hawaii rates for HCPCS J7606

Formoterol fumarate, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, 20 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.56 / $13.56 / $13.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.55 / $13.55 / $13.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.27 / $2.73
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.76 / $2.76 / $2.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.73 / $3.27 / $3.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.73 / $4.09
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.97 / $6.47 / $14.50