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North Dakota 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 / $55.16 / $99.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.16 / $55.16 / $66.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.85 / $60.15 / $60.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.87 / $60.06 / $60.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.60 / $55.15 / $68.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.23 / $55.44 / $236.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $55.16 / $61.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.06 / $55.16 / $66.45