go back

Wisconsin rates for HCPCS J7676

Pentamidine isethionate, inhalation solution, compounded product, administered through DME, unit dose form, per 300 mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $436.52 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.21 / $0.21 / $0.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $0.98 / $0.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $89.13
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.98 / $0.98 / $0.98