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Utah rates for HCPCS J7615

Levalbuterol, inhalation solution, compounded product, administered through DME, unit dose, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $0.93 / $1.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08