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Fomivirsen Injection

Nebraska rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Rates data updated July 2026.

Facilitymedian $1,000 · 10th–90th $1,000$1,5140%20%40%90th$1,000Professionalmedian $214 · 10th–90th $214$2750%50%90th$214$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$275.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,513.56
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$316.23