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South Carolina 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
$1.66 / $6.32 / $42.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.39 / $0.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $0.35 / $0.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.41 / $1.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $0.39 / $0.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.49
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.41 / $0.91
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $3.00 / $3.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.33 / $0.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.16 / $0.39 / $0.39