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Washington 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
$0.48 / $0.61 / $1.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.44 / $1.51
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $85.00 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.44 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $2.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $2.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $75.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.45 / $1.32
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $2.71 / $2.71
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.32 / $2.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44