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South Carolina rates for HCPCS J7639

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

Facilitymedian $209 · 10th–90th $58–$4570%20%10th90th$209Professionalmedian $55 · 10th–90th $50–$660%20%40%10th90th$55$1.0$5.0$20.0$100.0$500.0

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
$57.54 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $56.23 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $57.54 / $69.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $77.62 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $66.07
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $77.62
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $60.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $45.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.54 / $21.38 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $54.95 / $54.95