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Maine rates for HCPCS J7643

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

Facilitymedian $2 · 10th–90th $2–$20%50%10th$2Professionalmedian $1 · 10th–90th $1–$10%20%40%10th90th$1$0.5$1.0$2.0$5.0

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
$2.04 / $2.24 / $2.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.76 / $0.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.85 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.89 / $1.05 / $1.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.89 / $1.05 / $1.35