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Montana rates for HCPCS J7643

Glycopyrrolate Comp Unit

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $0.74 / $0.74
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 / $0.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.76 / $0.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $0.89 / $0.89