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New Hampshire rates for HCPCS J7677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.21 / $0.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.23 / $0.28 / $0.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.19 / $0.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.32 / $0.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.19
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.24 / $0.31