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Wisconsin 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
$1.66 / $1.66 / $3.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $1.72 / $2.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.06 / $2.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.99 / $1.80 / $2.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.77 / $0.94
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $1.76 / $3.45
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.41 / $2.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $1.81 / $95.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $4.17 / $5.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $90.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.66 / $1.76 / $3.45
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.41 / $2.41 / $2.41
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $95.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $1.67 / $3.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $4.17 / $5.00