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Rhode Island rates for HCPCS J1455

Foscarnet Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.26 / $52.26 / $52.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.58 / $15.58 / $66.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $16.07 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.74 / $16.07 / $16.07