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Montana 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
Professional
Modifier
Low / Median / High Price
$2.38 / $2.38 / $30.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.38 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.94 / $1.94 / $34.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.94 / $1.94 / $2.73
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.94 / $2.73 / $34.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.94 / $2.96 / $3.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.73 / $2.73 / $2.73