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Arkansas rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.76 / $13.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.54 / $0.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.71 / $0.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.45 / $0.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $1.15