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Washington rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Facilitymedian $1 · 10th–90th $1$20%20%10th90th$1Professionalmedian $1 · 10th–90th $0$20%20%10th90th$1$0.5$1.0$2.0$5.0$10.0$20.0$50.0

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
$1.05 / $1.20 / $1.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $1.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.45 / $0.52 / $0.85
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.78 / $0.85 / $0.85
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.78 / $0.78
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.42
Regence BlueShield
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 / $1.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.52 / $0.60 / $0.60
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.55 / $0.60