go back

Pennsylvania rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Facilitymedian $2 · 10th–90th $1–$20%20%40%10th90th$2Professionalmedian $2 · 10th–90th $0–$20%50%10th90th$2$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
Facility
Modifier
Typical Low / Median / Typical High
$1.10 / $1.58 / $1.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.55 / $1.70 / $1.74
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.55 / $0.65 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.62 / $0.62 / $0.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $1.48 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.63 / $0.72 / $0.72
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.70 / $1.70 / $1.70
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.58
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.38 / $0.52 / $0.58
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.38 / $0.52 / $0.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $1.10