go back

New Mexico rates for HCPCS J7640

Formoterol Inhalation Solution Compounded Product Administered Through Dme Unit Dose Form 12 Micrograms

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.80 / $2.80 / $2.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.45 / $2.54 / $2.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.73
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $2.50 / $2.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.52 / $1.52 / $1.52