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Georgia 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
$0.39 / $1.25 / $4.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.39 / $0.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.00 / $39.00 / $39.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.42 / $0.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.39 / $0.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.37 / $0.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.37 / $3.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.16 / $0.39 / $2.54