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Iowa rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $7.08 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $8.51 / $8.51
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $28.84 / $177.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $18.62 / $95.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $39.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $24.55 / $95.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $35.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $11.75
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22