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Virginia rates for HCPCS J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.50 / $695.24 / $1,382.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $581.26 / $730.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.50 / $1,191.29 / $1,881.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $575.50 / $771.40
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.51 / $606.35 / $606.35
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.37 / $489.18 / $575.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.52 / $598.52 / $960.81
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.55 / $644.54 / $1,666.03
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.50 / $690.60 / $863.25
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $690.60 / $863.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $610.03 / $644.55