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Montana rates for HCPCS J7669

Metaproterenol sulfate, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose form, per 10 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.43
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.44 / $0.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $79.43 / $85.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44