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Oregon rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $13.49 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.76 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $6.31 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $7.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $34.67 / $40.74
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $7.08 / $12.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $7.08 / $12.88
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $19.95 / $33.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $18.20 / $112.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $8.32 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $109.65 / $204.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $7.76