go back

West Virginia rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.58 / $15.58 / $16.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.74 / $16.07 / $16.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $24.12 / $24.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.17 / $16.07 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $99.76
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.07 / $16.07 / $72.48