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South Carolina 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
$0.46 / $0.46 / $1.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $1.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.26 / $8.26 / $8.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.44 / $0.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.44 / $0.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $2.77
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.48 / $2.93
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.28 / $0.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.44 / $0.44