go back

Montana rates for HCPCS J7643

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

Facilitymedian $1 · 10th–90th $0–$10%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$930%20%40%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.55 / $0.76 / $0.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $79.43 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.09 / $0.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.89 / $0.89 / $0.89