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New Mexico rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Facilitymedian $2 · 10th–90th $1–$69,1830%50%10th90th$2Professionalmedian $1 · 10th–90th $0–$20%20%40%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.40 / $0.42 / $0.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.52 / $0.52 / $0.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.52 / $0.60 / $0.60