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Fomivirsen Injection

Arizona rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Rates data updated July 2026.

How much rates vary

Facilitymedian $977 · 10th to 90th $851 to $1,148Professionalmedian $214 · 10th to 90th $214 to $214
$200.0$500.0$1.0Kfacility $977professional $214

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Medica
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$977.24
Typical High
$1,148.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80