go back

South Dakota rates for HCPCS J7644

Ipratropium bromide, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.39 / $3.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.66 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.39 / $0.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.43 / $0.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.28 / $0.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.44
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.43