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Hawaii rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.00 / $212.00 / $212.00
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.74 / $249.74 / $249.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.43 / $212.00 / $318.00