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South Carolina 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
$1.45 / $1.62 / $1.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.82 / $1.82 / $2.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.34 / $1.41
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.40 / $2.29
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.40 / $0.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.12 / $0.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.38 / $0.38