go back

Utah 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
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.42 / $2.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $0.91 / $2.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $0.91 / $1.05
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $0.81 / $0.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.44 / $1.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.91 / $0.91