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New York rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $8.91 / $16.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $18.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $87.10
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.72 / $6.31 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $100.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $10.00 / $28.18
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $8.32 / $15.14
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $60.26 / $60.26
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $60.26 / $60.26
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $50,118.72 / $75,857.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $21.88
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $60.26 / $60.26
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $16.60 / $72.44