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Indiana rates for HCPCS J7643

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

Facilitymedian $1 · 10th–90th $1–$20%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%20%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
$1.66 / $1.66 / $1.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $104.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.05 / $1.38 / $1.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $1.05 / $1.66
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.02 / $2.09 / $2.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.36 / $0.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.36 / $0.89 / $0.98