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Wisconsin rates for HCPCS J7640

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

Facilitymedian $2 · 10th–90th $1–$650%50%10th90th$2Professionalmedian $2 · 10th–90th $2–$30%50%10th90th$2$0.0$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
$2.00 / $2.34 / $2.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $3.63 / $5.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.74 / $1.91
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $2.34 / $2.95
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.79 / $0.79
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.34 / $3.55 / $95.50
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.62 / $1.51 / $2.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $89.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $64.57 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.62 / $1.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.51 / $1.82