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New Jersey rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $23.53 / $45.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.77 / $80.38 / $104.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.63 / $71.98 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.58 / $15.58 / $61.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $85.27