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Fomivirsen Injection

Ohio rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Rates data updated July 2026.

Facilitymedian $214 · 10th–90th $214$2140%50%100%$214Professionalmedian $50 · 10th–90th $40$8910%50%10th90th$50$50.0$100.0$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
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$50.12
Typical High
$50.12
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80