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West Virginia rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $6.76 / $6.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $6.76 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $100.00 / $100.00
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
$6.46 / $6.76 / $70.79