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Montana 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
Professional
Modifier
Low / Median / High Price
$0.27 / $0.33 / $0.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.08 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.33 / $0.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.33 / $0.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.33 / $0.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.30 / $0.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27