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Montana rates for HCPCS J7640

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

Facilitymedian $2 · 10th–90th $0–$30%20%10th90th$2Professionalmedian $2 · 10th–90th $2–$50%50%90th$2$0.2$1.0$5.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $2.51 / $2.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $79.43 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51