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Pennsylvania rates for HCPCS J7643

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

Facilitymedian $3 · 10th–90th $1–$8130%20%10th90th$3Professionalmedian $1 · 10th–90th $0–$7590%20%10th90th$1$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$1.23 / $1.23 / $1.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $758.58 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $1.45 / $2.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.23 / $1.23 / $1.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.36 / $0.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.36 / $0.89 / $1.02