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Maryland 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 / $1.19
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.87 / $2.87 / $2.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $34.00 / $34.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $1.04 / $1.10
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $1.19 / $1.19