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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
$6.03 / $79.43 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $7.08 / $79.43
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.24 / $16.60 / $17.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $16.22 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $51.29 / $407.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $15.49 / $19.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $26.30 / $28.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.76 / $21.88