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Kansas 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
$55.44 / $55.44 / $242.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $56.27 / $77.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.87 / $63.65 / $67.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.62 / $59.62 / $59.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.04 / $54.58 / $55.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.58 / $54.60 / $68.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.26 / $57.91 / $236.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.89 / $55.16 / $60.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $55.16 / $62.09