go back

Alabama rates for HCPCS J7642

Glycopyrrolate, inhalation solution, compounded product, administered through DME, concentrated form, per mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.01 / $1.01 / $1.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.01 / $1.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.04 / $1.04