go back

Arkansas 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.08 / $1.08 / $1.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.08 / $1.08 / $1.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.04 / $1.07