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Alabama rates for HCPCS J7639

Dornase alfa, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $138.04 / $186.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $85.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $21.38 / $54.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $54.95 / $54.95