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Arizona rates for HCPCS J7643

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

Facilitymedian $2 · 10th–90th $1–$30%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$10%50%10th90th$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
$1.55 / $1.66 / $3.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.26 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $1.12 / $1.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $1.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $95.50
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.89 / $0.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.36 / $0.36 / $0.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.89 / $0.89 / $0.89