go back

Massachusetts rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $9.33 / $11.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $18.62
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $33.88 / $70.79
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $8.32 / $70.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $56.23 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $8.32 / $15.14
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $33.88 / $70.79
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $8.32 / $70.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $35.48 / $46.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $70.79