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Ohio 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
$1.07 / $1.29 / $4.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.10 / $7.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.81 / $2.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.27 / $0.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.27 / $0.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $2.19
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.38 / $2.19
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $2.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.38 / $0.54
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.40 / $0.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.11 / $0.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.38 / $0.45