go back

Mississippi 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
$0.98 / $1.43 / $1.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $1.19 / $1.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.65 / $0.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $17.00 / $20.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.90 / $1.04 / $1.60