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New Hampshire rates for HCPCS J7639

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

Facilitymedian $69 · 10th–90th $55–$1480%20%10th90th$69Professionalmedian $55 · 10th–90th $55–$950%50%90th$55$0.1$0.5$2.0$10.0$50.0$200.0

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
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $61.66 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $57.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $204.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $109.65 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $89.13 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $21.38 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $54.95 / $85.11
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89