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Washington, DC rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $1.86 / $2.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.78 / $1.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.45 / $0.73