go back

Pennsylvania rates for HCPCS J7631

Cromolyn sodium, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.68 / $0.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.44 / $0.75
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.40 / $0.47 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.44 / $2.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.44 / $2.77
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $2.66 / $3.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.68 / $0.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.44 / $0.88
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.44 / $2.83
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.44 / $2.77
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.64 / $1.90
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $1.64 / $1.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.44 / $0.81