go back

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
$1.40 / $1.40 / $1.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $1.40 / $1.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.44 / $1.44 / $1.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.44 / $1.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09