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Pennsylvania rates for HCPCS J7658

Isoproterenol HCl, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, per mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.76 / $2.71 / $4.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.76 / $1.76
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.20 / $3.77 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.64 / $3.77 / $3.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.76 / $2.64 / $4.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.76 / $4.03
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.32
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $1.67 / $2.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.67 / $4.17 / $5.44