go back

Idaho rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.66 / $53.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.56 / $0.80
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.60 / $0.82
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.54 / $0.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.63