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Illinois rates for HCPCS J7643

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

Facilitymedian $2 · 10th–90th $1–$20%50%10th90th$2Professionalmedian $2 · 10th–90th $1–$600%20%10th90th$2$0.1$0.5$2.0$10.0$50.0$200.0

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
$1.35 / $1.55 / $1.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.55 / $1.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.02 / $1.41 / $1.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.89
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $57.54 / $75.86
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.36 / $0.76 / $0.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.78 / $0.89 / $0.91