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South Carolina rates for HCPCS J7643

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

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $1.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $1.12 / $1.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.56 / $0.76 / $0.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.36 / $0.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.36 / $0.89 / $0.89