go back

West Virginia 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 / $2.19 / $2.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $1.78 / $6.46
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $6.46 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $11.48 / $11.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $2.19 / $3.55