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Utah rates for HCPCS J7658

Isoproterenol Hcl Inhalation Solution Administered Through Dme Concentrated Form Per Milligram (Special Coverage Instructions Apply. See Mcm: 2100.5)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.72 / $1.72 / $1.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $1.72 / $1.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $92.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.09 / $2.09 / $2.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.17