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Fomivirsen Injection

South Dakota rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Rates data updated July 2026.

Facilitymedian $1,349 · 10th–90th $1,148$2,4550%20%10th90th$1,349Professionalmedian $219 · 10th–90th $214$2750%50%10th90th$219$200.0$500.0$1.0K$2.0K

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
$1,148.15
Median
$1,348.96
Typical High
$2,454.71
Medica
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$213.80
Typical High
$213.80