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Maine 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
$1.02 / $1.02 / $1.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.45 / $0.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.36 / $1.36 / $1.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $3.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $2.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.53
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.10
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.44 / $0.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.44 / $0.77