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Illinois rates for HCPCS J7643

Glycopyrrolate Comp Unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.34 / $1.56 / $1.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.76 / $0.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.12
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.68 / $57.40 / $76.61
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.89 / $0.94