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Washington, DC rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $43.94 / $59.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.60 / $57.60 / $57.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $15.17 / $16.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.67 / $13.67 / $16.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.63 / $16.07 / $26.06