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Iowa 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 / $1.19 / $3.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.99 / $1.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.41 / $1.41
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.60 / $36.25 / $43.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.62 / $4.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.04 / $1.81
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.00 / $5.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.80 / $5.54 / $5.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.04 / $1.71