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Oklahoma rates for HCPCS J1455

Foscarnet Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.58 / $16.82 / $28.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.36 / $17.36 / $17.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.00 / $42.58 / $67.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $15.17 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.91 / $16.07 / $16.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.58 / $17.67 / $94.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.58 / $15.58 / $21.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07