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Nationwide rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Facilitymedian $437 · 10th–90th $214–$1,4450%20%40%10th90th$437Professionalmedian $219 · 10th–90th $214–$8510%50%10th90th$219$0.2$2.0$20.0$200.0$2.0K$20.0K

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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $758.58 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $724.44 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $257.04 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $85.11 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $213.80 / $416.87

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