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Wisconsin rates for HCPCS J1165

Injection, phenytoin sodium, per 50 mg

Facilitymedian $1 · 10th–90th $1$20%20%10th90th$1Professionalmedian $1 · 10th–90th $0$10%20%40%10th90th$1$0.2$1.0$5.0$20.0$100.0

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
$1.20 / $1.35 / $1.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.82 / $3.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.52 / $0.52 / $0.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.42 / $0.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.56 / $1.07 / $1.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.76 / $1.10
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.45 / $0.45 / $1.00
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.89 / $0.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.66 / $0.66 / $1.41
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.66 / $0.66 / $1.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.68
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.42 / $0.52 / $1.07
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.59
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $1.29
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
$0.60 / $0.60 / $0.89