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Minnesota rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $6.03 / $13.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $57.54 / $57.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $6.76 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.61 / $12.59 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $7.94 / $8.71
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $12.02 / $14.13
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $9.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $15.49 / $26.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $23.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $48.98