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Fomivirsen Injection

Minnesota rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Rates data updated July 2026.

How much does Fomivirsen Injection cost?

$224per 1.65 mg

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $224 for each 1.65 mg of this drug. The price depends on where it is billed: about $219 from a physician practice, and about $562 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Work out the cost of a dose

This drug is priced per 1.65 mg. Enter the amount given to see what insurers have agreed to pay for it.

mg
In a doctor's office or clinic
$219
At a hospital outpatient department
$562

The same drug, in the same amount, costs 157% more at a hospital than at a doctor's office.

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$219$219 to $234
FacilityA hospital or hospital-owned outpatient department$562$550 to $692

How much rates vary

Facilitymedian $562 · 10th to 90th $550 to $832Professionalmedian $219 · 10th to 90th $219 to $295
$200$500$1Kfacility $562professional $219

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$616.60
Typical High
$724.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$257.04
Typical High
$281.84
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$562.34
Typical High
$831.76
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$1,148.15
Typical High
$1,698.24
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$295.12

Where Minnesota sits

The same service costs 2089.3 times more in Indiana than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Minnesota· 14th of 34

$224

IN $63,096SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.