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Utah 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
$2.00 / $2.00 / $20.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $3.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2.88 / $6.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $6.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $2.24 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.51
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $1.78 / $1.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.45 / $2.75 / $3.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $2.19 / $2.19