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Pennsylvania rates for HCPCS J7620

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, FDA-approved final product, noncompounded, administered through DME

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.40 / $2.89 / $9.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.23 / $0.78
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.21 / $0.25 / $437.90
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.21 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.20 / $0.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.41
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $1.75 / $2.19
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.81 / $4.88 / $8.08
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.21 / $0.24 / $420.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $3.14 / $11.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.23 / $0.76
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.20 / $0.41
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.20 / $0.41
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.20 / $0.37