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Montana rates for HCPCS J7677

Revefenacin inhalation solution, FDA-approved final product, noncompounded, administered through DME, 1 mcg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.23 / $0.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.22 / $0.22
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.22 / $0.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.21 / $0.21 / $0.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.19