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Virginia rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $17.87 / $35.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.88 / $16.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $33.93 / $54.67
Anthem 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 / $15.17 / $16.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.67 / $19.30 / $85.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $25.71
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.28 / $19.46 / $74.62
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.28 / $19.46 / $74.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.82 / $16.07 / $20.18