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Pennsylvania 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
$2.02 / $4.61 / $8.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.38 / $2.73 / $4.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $2.96 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.83 / $2.83 / $2.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $2.73 / $6.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.73 / $6.46
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.36 / $16.95 / $21.19
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.99 / $4.61 / $5.99
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.99 / $2.73 / $5.99
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.57 / $2.73 / $6.46
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.73 / $6.46
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.47 / $6.47 / $7.51
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.47 / $6.47 / $7.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $2.73 / $5.00