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North Carolina 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
$0.76 / $1.02 / $44.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.81 / $1.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $0.85 / $0.85
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 / $1.12
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.86
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.89 / $0.92
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.00 / $95.00 / $100.00