Duopa (Carbidopa / Levodopa Enteral Suspension — PEG-J Pump, HCPCS J7340): Cost Across Insurances
Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.
Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.
Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.
| Parkinson's Service / Medication | Self-Pay / Cash Price Hospital MRF / Retail Cash | Medicare Rate 2026 CMS / NADAC / Part D | Anthem Blue Cross MRF Negotiated / Formulary | Blue Shield of CA MRF Negotiated / Formulary | UnitedHealthcare MRF Negotiated / Formulary | Aetna MRF Negotiated / Formulary | Cigna MRF Negotiated / Formulary | Kaiser Permanente MRF Negotiated / Formulary | Medi-Cal (CA Medicaid) CA DHCS / Medi-Cal Rx |
|---|---|---|---|---|---|---|---|---|---|
MedicationSpecialty / DME (00074301228) Duopa (Carbidopa / Levodopa Enteral Suspension — PEG-J Pump, HCPCS J7340) | $7,200 – $8,800 / 30 days (30 enteral cassettes + pump supplies) $7,200 – $8,800 / 30 days (30 enteral cassettes + pump supplies) Source: CMS Medicare Part B ASP Drug Pricing File (HCPCS J7340) & Specialty Infusion Benchmarks (Oct 2026) Date: Oct 2026 | Not published Not published in CMS Retail NADAC (Dispensed as Medicare Part B DME Enteral Infusion Drug under HCPCS J7340) • Medicare Part D patient cost: Original Medicare + Medigap Plan G/N: $0 after $257 Part B deductible • Medicare Advantage / Original Medicare alone: 20% Part B coinsurance (up to Part C MOOP) Source: CMS NADAC 2026 & CMS Medicare Part B ASP Pricing File (HCPCS J7340, Oct 2026) & CMS Medicare Benefit Policy Manual Ch. 15 §110 (DME External Infusion Pumps) & HCPCS J7340 Date: 2026-10-28 | Not published Medical/Specialty Pharmacy Benefit; Prior Authorization required (CG-DRUG-68). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Anthem Blue Cross 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Medical/Specialty Benefit; Prior Authorization required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Blue Shield of CA 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Medical/Specialty Benefit; Prior Authorization required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: UnitedHealthcare 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Medical/Specialty Benefit; Prior Authorization required (CPB 0017 / Specialty). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Aetna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Medical/Specialty Benefit; Prior Authorization required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Cigna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | Not published Requires movement-disorder subspecialist board review and authorization. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved. Source: Kaiser Permanente 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021) Date: Oct 2026 | $0 patient copay $0 copay with approved TAR / Medi-Cal Rx Prior Authorization. Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy Date: Oct 2026 |
Every Insurance Cell for Duopa — With Source & Date Citations
Self-Pay / Discounted Cash Price
$7,200 – $8,800 / 30 days (30 enteral cassettes + pump supplies)
Original Medicare (CMS 2026 / NADAC / Part D)
Not published in CMS Retail NADAC (Dispensed as Medicare Part B DME Enteral Infusion Drug under HCPCS J7340) • Medicare Part D patient cost: Original Medicare + Medigap Plan G/N: $0 after $257 Part B deductible • Medicare Advantage / Original Medicare alone: 20% Part B coinsurance (up to Part C MOOP)
Anthem Blue Cross (California)
Medical/Specialty Pharmacy Benefit; Prior Authorization required (CG-DRUG-68). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Blue Shield of California
Medical/Specialty Benefit; Prior Authorization required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
UnitedHealthcare (UHC)
Medical/Specialty Benefit; Prior Authorization required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Aetna
Medical/Specialty Benefit; Prior Authorization required (CPB 0017 / Specialty). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Cigna
Medical/Specialty Benefit; Prior Authorization required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Kaiser Permanente (Northern CA)
Requires movement-disorder subspecialist board review and authorization. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.
Medi-Cal (California Medicaid / Medi-Cal Rx)
$0 copay with approved TAR / Medi-Cal Rx Prior Authorization.
Duopa (Carbidopa / Levodopa Enteral Suspension — PEG-J Pump, HCPCS J7340) — Clinical & Formulary Summary
What it's for: Continuous 16-hour infusion of carbidopa/levodopa gel delivered directly into the small intestine (jejunum) via a portable CADD-Legacy pump and PEG-J tube to bypass erratic gastric emptying in advanced Parkinson's. (Source: FDA Prescribing Information (NDA 203952) & CMS Medicare Part B DMEPOS Policy)