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Texas rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Facilitymedian $2,138 · 10th–90th $275–$2,3440%20%40%10th90th$2,138Professionalmedian $214 · 10th–90th $214–$2140%50%$214$50.0$100.0$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
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,344.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $707.95 / $1,148.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80