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Nebraska 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
$0.30 / $0.36 / $0.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.50 / $1.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.31 / $0.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.31 / $0.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.18 / $2.18 / $2.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.35 / $2.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.36 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.30 / $0.45
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.23 / $0.34 / $0.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.34 / $0.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.27 / $0.41