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Mississippi 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
$57.92 / $66.19 / $66.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $57.92 / $73.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.28 / $39.28 / $43.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.58 / $55.16 / $55.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.58 / $55.16 / $55.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.64 / $55.16 / $71.70