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Kansas rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.90 / $68.55 / $78.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.39 / $22.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.91 / $72.83 / $96.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $17.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $16.07 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.58 / $21.82 / $94.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.58 / $15.58 / $24.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $27.34