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Hawaii rates for HCPCS J7643

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

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.13
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.83 / $0.89 / $1.34