go back

Michigan 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 / $0.39 / $15.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.28 / $0.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.27 / $0.36
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.18 / $0.18
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.27 / $2.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.28 / $2.18
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.54 / $11.38
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.28 / $0.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.28 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.21 / $0.27 / $0.30