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Minnesota rates for HCPCS J7640

Formoterol, inhalation solution, compounded product, administered through DME, unit dose form, 12 mcg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $2.95 / $2.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.36 / $2.45 / $2.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.09 / $7.34 / $11.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.08 / $5.09 / $5.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.78 / $4.78 / $5.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.52 / $1.76 / $1.91
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.39 / $4.22 / $5.47
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.50 / $2.59 / $95.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.52 / $1.52 / $2.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.52 / $1.52 / $2.76