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Montana rates for HCPCS J7639

Dornase alfa, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per mg

Facilitymedian $62 · 10th–90th $46–$1620%20%40%10th90th$62Professionalmedian $56 · 10th–90th $55–$1450%50%10th90th$56$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $61.66 / $61.66
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $54.95 / $102.33
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $54.95 / $102.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $61.66 / $97.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $61.66 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $5.37 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95