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Kentucky 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 / $2.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.95 / $1.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.18 / $1.23 / $1.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $1.09 / $1.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $44,449.56 / $52,149.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,499.57 / $48,999.51 / $50,749.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.43 / $1.43 / $2.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.04 / $1.07