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Florida 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 / $100.00 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $54.95 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $56.23
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $54.95 / $54.95
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $58.88 / $58.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $43.65 / $54.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $21.38 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $54.95 / $54.95
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $54.95 / $58.88