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Utah rates for HCPCS J7639

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

Facilitymedian $83 · 10th–90th $63–$1230%20%40%10th90th$83Professionalmedian $58 · 10th–90th $55–$1290%50%10th90th$58$0.1$0.5$2.0$10.0$50.0

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
$63.10 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $63.10 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $72.44 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $45.71 / $72.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $66.07
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $57.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $66.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $54.95 / $54.95