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Alabama rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $8.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $263.03 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.61 / $6.76 / $13.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $22.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $38.02