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Dornase Alfa Inhalation Solution

Nebraska rates for HCPCS J7639 · Pulmozyme

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

Rates data updated October 2026.

How much does Pulmozyme (dornase alfa) cost?

$54.95per mg

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $54.95 for each mg of this drug. The price depends on where it is billed: about $54.95 from a physician practice, and about $60.26 from a hospital or other facility.

Work out the cost of a dose

This drug is priced per mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$54.95
At a hospital outpatient department
$60.26

The same drug, in the same amount, costs 10% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$54.95$52.48 to $63.10
FacilityA hospital or hospital-owned outpatient department$60.26$54.95 to $63.10

How much rates vary

Facilitymedian $60 · 10th to 90th $48 to $65Professionalmedian $55 · 10th to 90th $22 to $65
$0.1$1$10$100facility $60professional $55

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$57.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$56.23
Typical High
$58.88
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$63.10
Typical High
$64.57
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$63.10
Typical High
$63.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$66.07
Typical High
$72.44
Medica
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$104.71
Typical High
$234.42
Medica
Setting
Professional
Modifier
None
Typical Low
$21.88
Median
$53.70
Typical High
$57.54
Midlands
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$66.07
Typical High
$67.61
United
Setting
Professional
Modifier
None
Typical Low
$21.88
Median
$52.48
Typical High
$60.26
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$27.54
Median
$28.18
Typical High
$29.51
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$11.48
Typical High
$11.75
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$8.32
Median
$8.51
Typical High
$8.71
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.50
Median
$5.62
Typical High
$5.89

Where Nebraska sits

The same service costs 1.6 times more in Alaska than in Louisiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Nebraska· 41st of 51

$54.95

AK $83.18LA $52.48

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.