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Montana rates for HCPCS J7642

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

Facilitymedian $33 · 10th–90th $1–$91,2010%10%20%10th90th$33Professionalmedian $2 · 10th–90th $1–$600%20%10th90th$2$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.58 / $2.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.28 / $0.28 / $1.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.05 / $1.05