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Maryland 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 / $285.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.88
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $0.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.57
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $1.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.73
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.47