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Pennsylvania rates for HCPCS J7635

Atropine Inhalation Solution Administered Through Dme Concentrated Form Per Milligram (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.10 / $0.15 / $0.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.10 / $0.10
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.76 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.47
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.10 / $0.15 / $0.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.10 / $0.23
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.59
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.59 / $3.59 / $3.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.12 / $0.22