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Kansas rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.89 / $2.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.49 / $0.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $0.77 / $1.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $0.49
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.65 / $1.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.66 / $0.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.72