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Alaska rates for HCPCS J7644

Ipratropium Bromide Inhalation Solution Administered Through Dme Unit Dose Form Per Milligram (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.36 / $2.56 / $9.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.59 / $0.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.43 / $1.26
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.78 / $1.23
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.62 / $0.67
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $1.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.43 / $0.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.59 / $1.17