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Wisconsin rates for HCPCS J7642

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

Facilitymedian $2 · 10th–90th $0–$420%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%10th90th$1$0.1$0.5$2.0$10.0$50.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $2.14 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.05 / $1.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.48 / $2.69 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.26 / $1.45
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.95 / $1.00 / $2.82
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $1.58 / $1.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.95 / $1.05 / $95.50
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.05 / $2.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $58.88 / $89.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $14.13 / $15.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.42 / $1.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.87 / $1.05 / $1.48