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Colorado 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
$0.95 / $0.95 / $3.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.95 / $0.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $1.04 / $187.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.95 / $1.01 / $1.60
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.97 / $0.97 / $1.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.04