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Texas rates for HCPCS J7643

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

Facilitymedian $2 · 10th–90th $1–$80%10%10th90th$2Professionalmedian $1 · 10th–90th $1–$10%20%10th90th$1$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$3.55 / $47.86 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.02 / $3.55
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.74 / $1.70 / $3.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.74 / $0.74 / $0.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $1.70 / $5.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.89 / $3.55
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.72 / $0.81 / $3.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $2,754.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.85 / $2.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
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