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Vermont rates for HCPCS J1455

Foscarnet Sodium Injection

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $26.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $18.20 / $18.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $24.49 / $40.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $24.49 / $40.81
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.72 / $59.60