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Montana 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
Professional
Modifier
Low / Median / High Price
$0.35 / $0.35 / $7.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.34 / $11.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.34 / $0.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.44 / $11.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.47 / $0.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44