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Oklahoma rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.71 / $1.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $0.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.86 / $1.36
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 / $0.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.75 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.66 / $0.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.48