go back

Washington, DC 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
$55.16 / $155.55 / $209.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $55.16 / $55.16
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.15 / $83.18 / $140.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.04 / $52.04 / $55.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.85 / $46.89 / $55.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.20 / $55.16 / $55.16