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Minnesota rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $1.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $1.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.99 / $1.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.66 / $0.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $1.43 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.56 / $0.67
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.31 / $1.64
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.53 / $0.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $1.05 / $1.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.66 / $1.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.82