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Pennsylvania rates for HCPCS J7639

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

Facilitymedian $105 · 10th–90th $56–$1660%10%20%10th90th$105Professionalmedian $55 · 10th–90th $55–$690%50%90th$55$0.1$1.0$10.0$100.0$1.0K$10.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $109.65 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $60.26 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $91.20 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $56.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $47.86 / $56.23
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $95.50
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $83.18 / $144.54
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $57.54
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $57.54 / $245.47
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $57.54 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.54 / $21.38 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $54.95 / $66.07