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Missouri rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $1.02 / $1.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.53 / $1.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.77 / $1.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.56
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
$0.54 / $1.69 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.66 / $0.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.45 / $0.56