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Hawaii rates for HCPCS J7642

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

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.13 / $1.13
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.97 / $1.04 / $1.56