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Colorado 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 / $109.77 / $139.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $55.16 / $70.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.26 / $100.94 / $177.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $55.16 / $55.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.04 / $52.04 / $78.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.58 / $55.16 / $55.16
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.20 / $57.92 / $91.51
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.89 / $57.92 / $77.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.37 / $60.68 / $78.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.42 / $88.42 / $88.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $55.16 / $55.16