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North Dakota 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 / $1.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.49 / $0.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.49 / $0.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.66 / $1.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.66 / $0.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.45 / $0.49