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Pennsylvania 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 / $0.44 / $0.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.28
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.17 / $0.20 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.19 / $0.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.31
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.28 / $0.36
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.38 / $0.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.20 / $0.57
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.19 / $0.31
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.31
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.22
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.19 / $0.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.19 / $0.31