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Utah rates for HCPCS J7643

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

Facilitymedian $1 · 10th–90th $0–$10%50%10th$1Professionalmedian $1 · 10th–90th $1–$10%50%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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $1.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.45 / $0.45 / $0.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.89 / $0.89 / $0.89