HCPCS J1455
Injection, foscarnet sodium, per 1000 mg
Current code41 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $119 – $176 | — | — |
| Deaconess Medical Center | $109 – $115 | — | — |
| Harborview Medical Center | — | — | — |
| Highline Medical Center | — | $2,074 – $3,267 | $6,791 – $10,701 |
| Island Hospital | $112 – $122 | — | — |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | $113 – $122 | — | — |
| MultiCare Auburn Medical Center | $111 – $120 | — | — |
| MultiCare Covington Medical Center | $111 – $120 | — | — |
| MultiCare Good Samaritan Hospital | $113 – $122 | — | — |
| MultiCare Valley Hospital | $108 – $115 | — | — |
| Olympic Medical Center | $139 – $153 | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| PeaceHealth Peace Island Medical Center | — | $423 – $468 | $651 – $720 |
| PeaceHealth Southwest Medical Cente | — | $423 – $468 | $651 – $720 |
| PeaceHealth St John Medical Center | — | $423 – $468 | $651 – $720 |
| PeaceHealth St Joseph Medical Center | — | $423 – $468 | $651 – $720 |
| PeaceHealth United General Medical Center | — | $423 – $468 | $651 – $720 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $817 – $1,367 | $1,167 – $1,953 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | $817 – $1,367 | $1,167 – $1,953 |
| Providence Mount Carmel Hospital | — | $817 | $1,167 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | $1,182 – $1,482 | $2,274 – $2,850 |
| Seattle Children's Hospital | — | $3,123 | $3,123 |
| St Anthony Hospital | — | $2,066 – $3,255 | $6,791 – $10,701 |
| St Clare Hospital | — | $1,958 – $3,084 | $6,791 – $10,701 |
| St Elizabeth Hospital | $1,155 – $2,215 | $2,400 – $3,781 | $6,791 – $10,701 |
| St Francis Community Hospital | — | $2,131 – $3,358 | $6,791 – $10,701 |
| St Joseph Medical Center | — | $2,249 – $3,544 | $6,791 – $10,701 |
| St Michael Medical Center | — | $2,997 – $4,723 | $6,791 – $10,701 |
| Swedish Edmonds Hospital | — | $825 | $1,718 |
| Swedish Issaquah | — | $825 | $1,718 |
| Swedish Medical Center | — | $825 – $1,150 | $1,718 – $2,396 |
| Swedish Medical Center / Cherry Hill | — | $825 – $1,150 | $1,718 – $2,396 |
| Tacoma General Allenmore Hospital | $113 – $122 | — | — |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | $42.54 – $150 | $83.41 – $294 |
| Yakima Valley Memorial | $108 – $126 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.