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Indiana rates for HCPCS J1455

Foscarnet Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.74 / $70.11 / $157.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.23 / $16.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $32.15 / $42.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.66 / $16.07 / $22.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $21.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $20.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $16.07 / $183.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $32.15