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Montana rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Facilitymedian $1 · 10th–90th $1–$20%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$20%20%10th90th$1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.74 / $1.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $1.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.59
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $0.68 / $1.41
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.41 / $0.68 / $1.41
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $1.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60