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.
Original text from hospital filings
foscarnet 24 mg/mL Soln 250 mL BOTTLE
Rapids, MN
See all hospitals reporting HCPCS J1455 →Price type
Allina Health Systems’s median price of $640 is 967% above the median hospital's median price ($60), higher than 85% of the 1,621 hospitals reporting HCPCS J1455. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 22 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare united healthcare (um) facility · case rate · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Bcbs Mn bc pmap (amu) facility · other · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 3 | Bcbs Mn bc premier (m u) facility · other · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 4 | Blue Cross Blue Shield bc aehp (mu) facility · other · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 5 | Bcbs Mn bc state health plan (mu) facility · other · outpatient | $30 | $30 | — | — | — | $30 – $30 |
| 6 | Bcbs Mn bc high value/performance network (mu) facility · other · outpatient | $31 | $31 | — | — | — | $31 – $31 |
| 7 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $264 | $264 | $36 | 14% | — | $228 – $299 |
| 8 | Medica medica pmap (um) facility · percent of total billed charges · outpatientfrom % of charges | $291 | $291 | $39 | 14% | — | $252 – $330 |
| 9 | Aetna aetna elevate (amu) facility · percent of total billed charges · outpatientfrom % of charges | $462 | $462 | $62 | 14% | — | $400 – $525 |
| 10 | Aetna aetna performance (amu) facility · percent of total billed charges · outpatientfrom % of charges | $492 | $492 | $66 | 14% | — | $425 – $558 |
| 11 | Medica medica dual solutions (m) facility · percent of total billed charges · outpatientfrom % of charges | $582 | $582 | $79 | 14% | — | $504 – $661 |
| 12 | Aetna aetna direct network (amu) facility · percent of total billed charges · outpatientfrom % of charges | $717 | $717 | $97 | 14% | — | $620 – $813 |
| 13 | Bcbs Mn bc aware/blue plus (a m u) facility · percent of total billed charges · outpatientfrom % of charges | $770 | $770 | $104 | 14% | — | $666 – $874 |
| 14 | Medica medica ubh (m) facility · percent of total billed charges · inpatientfrom % of charges | $918 | $918 | $124 | 14% | — | $794 – $1.0k |
| 15 | Medica medica elect (u m) facility · percent of total billed charges · outpatientfrom % of charges | $940 | $940 | $127 | 14% | — | $813 – $1.1k |
| 16 | Medica medica essentials (u m) facility · percent of total billed charges · outpatientfrom % of charges | $982 | $982 | $133 | 14% | — | $849 – $1.1k |
| 17 | Medica medica mhps (u m) facility · percent of total billed charges · outpatientfrom % of charges | $982 | $982 | $133 | 14% | — | $849 – $1.1k |
| 18 | Medica medica choice (u m) facility · percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | $140 | 14% | — | $894 – $1.2k |
| 19 | Medica medica ubh pmap (m) facility · percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | $142 | 14% | — | $907 – $1.2k |
| 20 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $1.1k | $1.1k | $149 | 14% | — | $953 – $1.3k |
| 21 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | $149 | 14% | — | $953 – $1.3k |
| 22 | Medica medica ubh (m) facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | $149 | 14% | — | $953 – $1.3k |
Last updated: Jun 17, 2026
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