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Louisiana rates for HCPCS J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.02 / $612.41 / $1,340.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $581.26 / $733.68
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.75 / $1,125.75 / $1,125.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.85 / $512.57 / $696.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.17 / $696.17 / $710.09
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$650.14 / $650.14 / $650.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.92 / $542.92 / $575.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $575.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.18 / $575.50 / $634.49