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Pennsylvania rates for HCPCS J7640

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

Facilitymedian $4 · 10th–90th $3–$70%20%10th90th$4Professionalmedian $2 · 10th–90th $2–$30%50%90th$2$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$2.51 / $4.57 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.45 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $3.31 / $6.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $3.80 / $3.98
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.62 / $0.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.62 / $1.51 / $1.74