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Fomivirsen Injection

Minnesota rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Rates data updated July 2026.

Facilitymedian $562 · 10th–90th $550$8320%20%10th90th$562Professionalmedian $219 · 10th–90th $219$2950%50%90th$219$200.0$500.0$1.0K

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
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