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Arizona rates for HCPCS J7612

Levalbuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.54 / $0.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.32 / $0.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.24 / $0.93 / $1.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.27 / $0.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.27 / $0.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $2.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.32 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27