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Illinois rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Facilitymedian $759 · 10th–90th $427–$3,0200%5%10%10th90th$759Professionalmedian $224 · 10th–90th $120–$1,4130%20%10th90th$224$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $346.74 / $2,137.96
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $223.87