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Kentucky rates for HCPCS J7643

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.71 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.18 / $1.23 / $1.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.81 / $1.09 / $1.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $44,449.56 / $52,149.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,499.57 / $48,999.51 / $50,749.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $70.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.89 / $0.89