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Utah rates for HCPCS J7685

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $61.66 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $51.29 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $51.29 / $69.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $27.54 / $32.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $7.41 / $7.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.59 / $12.59 / $12.59