go back

Texas 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
$0.32 / $0.44 / $0.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.44 / $0.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.79 / $14.44 / $30.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $1.96 / $1.96
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $0.91 / $0.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.44 / $2.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $2.77
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.44 / $0.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.44 / $2.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.44 / $0.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $2.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.44 / $0.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.21 / $0.28 / $0.59