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Utah rates for HCPCS J7612

Levalbuterol Inhalation Solution Fda-Approved Final Product Non-Compounded Administered Through Dme Concentrated Form 0.5 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.45 / $2.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $2.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.27 / $0.39
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27