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Washington rates for HCPCS J1452

Injection, fomivirsen sodium, intraocular, 1.65 mg

Facilitymedian $214 · 10th–90th $214–$2140%50%100%$214Professionalmedian $214 · 10th–90th $214–$3550%50%90th$214$100.0$200.0$500.0

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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $213.80 / $562.34
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $257.04