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Georgia rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.66 / $3.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.46 / $0.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.49 / $0.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.76 / $0.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $1.15