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South Carolina rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $22.39 / $28.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $7.08 / $79.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $27.54 / $66.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $58.88 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $9.12 / $79.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $19.95 / $97.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $21.88