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Missouri rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $78.55 / $106.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.55 / $78.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $17.53 / $57.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $20.10
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 / $44.68 / $411.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.24 / $15.58 / $19.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.67 / $16.07 / $20.05