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Washington 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
$0.26 / $0.51 / $0.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.30 / $0.38
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $95.00 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.30 / $2.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.26 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $2.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $75.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.34 / $0.81
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $2.13 / $2.13
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.44 / $2.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.33
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27