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Maine 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
$0.40 / $0.90 / $0.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.41 / $0.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.47
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $0.90 / $0.98
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.41 / $0.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.39 / $0.59