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California 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
$1.02 / $25.70 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.39 / $1.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.41 / $0.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.38 / $0.91
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $2.45 / $2.69
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.41 / $0.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.38 / $0.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $2.19
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.27 / $0.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.38 / $1.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.40 / $0.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $2.19
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $1.05 / $1.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.38 / $0.93