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Montana rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Facilitymedian $89 · 10th–90th $89–$1070%20%40%90th$89Professionalmedian $89 · 10th–90th $89–$1070%20%40%90th$89$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $107.15
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $107.15