go back

Indiana rates for HCPCS J7631

Cromolyn Sodium Inhalation Solution Administered Through Dme Unit Dose Form Per 10 Milligrams (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $1.06 / $1.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.44 / $0.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.88 / $1.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.44 / $0.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.44 / $2.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.44 / $0.60