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Arkansas rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.92 / $19.29 / $19.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $19.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.91 / $16.91 / $16.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.91 / $16.91 / $22.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $16.07 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $72.48