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Ohio rates for HCPCS J7643

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

Facilitymedian $2 · 10th–90th $1–$100%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%10%20%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $2.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $79.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.12 / $1.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $1.62 / $2.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.70 / $2.29
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.36 / $0.36 / $0.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.36 / $0.89 / $0.89