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 SOD INJ 6 GRAM
Hialeah, FL
See all hospitals reporting HCPCS J1455 →Price type
Hsa Pgh Llc’s median price of $654 is 989% above the median hospital's median price ($60), higher than 86% of the 1,615 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: 10 payers, 21 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 | Aetna Better Health aetna better health medicaid hmo facility · fee schedule · outpatient | $68 | $68 | — | — | — | $68 – $68 |
| 2 | Humana humana medical plan / fl medicaid facility · fee schedule · outpatient | $68 | $68 | — | — | — | $68 – $68 |
| 3 | UnitedHealthcare united healthcare medicaid hmo facility · fee schedule · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Molina molina managed medicaid facility · other · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 5 | Cigna cigna individual family facility · fee schedule · outpatient | $161 | $161 | — | — | — | $161 – $161 |
| 6 | Cigna cigna surefit facility · fee schedule · outpatient | $198 | $198 | — | — | — | $198 – $198 |
| 7 | Cigna cigna commercial facility · fee schedule · outpatient | $230 | $230 | — | — | — | $230 – $230 |
| 8 | Cigna cigna localplus benefit facility · fee schedule · outpatient | $230 | $230 | — | — | — | $230 – $230 |
| 9 | Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · inpatientfrom % of charges | $576 | $576 | — | — | — | $576 – $576 |
| 10 | Amerihealth Caritas amerihealth caritas medicaid facility · percent of total billed charges · outpatientfrom % of charges | $576 | $576 | — | — | — | $576 – $576 |
| 11 | Humana humana commercial hmo facility · percent of total billed charges · inpatientfrom % of charges | $654 | $654 | — | — | — | $654 – $654 |
| 12 | Humana humana commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $654 | $654 | — | — | — | $654 – $654 |
| 13 | Humana humana commercial ppo facility · percent of total billed charges · inpatientfrom % of charges | $654 | $654 | — | — | — | $654 – $654 |
| 14 | Humana humana commercial ppo facility · percent of total billed charges · outpatientfrom % of charges | $654 | $654 | — | — | — | $654 – $654 |
| 15 | Cigna cigna behavioral health facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 16 | Aetna aetna signature administrators (asa) facility · percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | Aetna aetna signature administrators (asa) facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 18 | Magellan magellan behavioral health facility · percent of total billed charges · outpatientfrom % of charges | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 19 | First Health first health facility · percent of total billed charges · inpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 20 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 21 | Tricare tricare traditional facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
Last updated: Sep 1, 2026
See Foscarnet sodium injection, per 1000 mg pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.