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Massachusetts rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $16.07 / $32.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.72 / $18.70
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.57 / $48.00 / $86.40
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $72.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.25 / $20.52 / $43.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $53.00 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.28 / $16.07 / $33.39
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.40 / $86.40 / $411.35
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $72.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $72.48