go back

Wyoming rates for HCPCS J7643

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.50 / $50.00 / $50.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $0.76 / $0.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.89 / $0.89