Foscarnet sodium injection, per 1000 mg

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

FOSCARNET IV SYRINGE 24 MG/ML (NEO/PED) (CENTRAL LINE ONLY)

Payers reporting HCPCS J1455

Payer pricing summary

Low

$17

Average

$451

Median

$360

High

$1.8k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +27 other terms	585	$26	$189	$1.2k	616%	—	$0 – $10.7k
2	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	334	$79	$200	$415	208%	—	$0 – $2.8k
3	Cigna fee schedule · outpatient · +22 other terms	312	$43	$197	$552	280%	—	$2 – $5.4k
4	Aetna fee schedule · outpatient · +23 other terms	300	$40	$262	$962	368%	—	$1 – $10.3k
5	Humana fee schedule · outpatient · +21 other terms	275	$21	$136	$243	178%	—	$0 – $2.1k
6	Anthem fee schedule · outpatient · +23 other terms	125	$39	$88	$139	157%	—	$3 – $1.0k
7	Molina fee schedule · outpatient · +25 other terms	99	$38	$152	$488	321%	—	$1 – $4.4k
8	WellCare fee schedule · outpatient · +12 other terms	82	$37	$43	$71	164%	—	$16 – $345
9	MultiPlan fee schedule · outpatient · +14 other terms	73	$970	$1.5k	$2.1k	136%	—	$1 – $9.6k
10	Kaiser fee schedule · both · +18 other terms	52	$19	$27	$35	132%	—	$15 – $190
11	Caresource fee schedule · outpatient · +13 other terms	46	$22	$49	$104	213%	—	$1 – $690
12	Highmark facility · fee schedule · outpatient · +13 other terms	44	$21	$48	$41	86%	—	$7 – $191
13	Optum facility · fee schedule · outpatient · +18 other terms	34	$44	$38	$17	46%	—	$7 – $59
14	Ambetter facility · fee schedule · outpatient · +12 other terms	32	$39	$55	$35	63%	—	$0 – $98
15	Devoted fee schedule · outpatient · +8 other terms	32	$40	$32	$14	43%	—	$16 – $70
16	Oscar facility · fee schedule · outpatient · +12 other terms	32	$19	$25	$10	39%	—	$7 – $93
17	Bcbs Tx fee schedule · outpatient · +3 other terms	31	$289	$270	$132	49%	—	$36 – $529
18	Medica fee schedule · outpatient · +14 other terms	31	$137	$201	$240	119%	—	$0 – $1.5k
19	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$1.4k	$1.2k	$198	16%	—	$974 – $1.5k
20	Amerihealth Caritas facility · fee schedule · outpatient · +10 other terms	22	$16	$29	$54	185%	—	$16 – $259
21	Tricare facility · fee schedule · outpatient · +12 other terms	22	$38	$971	$847	87%	—	$4 – $2.1k
22	First Health fee schedule · outpatient · +13 other terms	20	$1.0k	$1.2k	$834	70%	—	$16 – $3.7k
23	Clover fee schedule · outpatient · +5 other terms	19	$42	$25	$12	49%	—	$16 – $45
24	Aetna Better Health fee schedule · outpatient · +14 other terms	18	$16	$33	$26	79%	—	$7 – $69
25	Healthpartners fee schedule · outpatient · +9 other terms	18	$46	$46	$1	2%	—	$45 – $47

Page 1 of 3 · 59 payers