go back

New Jersey 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 / $2.40 / $29.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.74 / $0.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.76 / $0.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.12
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.05 / $1.05
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 / $0.93