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Alabama rates for HCPCS J7639

Dornase Alpha Inhalation Solution Administered Through Dme Unit Dose Form Per Milligram (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.16 / $74.45 / $74.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $55.16 / $57.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.43 / $135.22 / $181.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.12 / $31.12 / $31.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.16 / $55.16 / $55.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.58 / $55.16 / $68.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.59 / $53.59 / $65.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $55.16 / $55.16