What is the standard insurance baseline for HCPCS J1456?

The standard insurance baseline reimbursement rate is $0.33. This represents the customary allowable amount established across standard fee schedules.

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HCPCS J1456Medical Service

Injection Fosaprepitant Teva Not Therapeutically Equivalent to J1453 1 Mg

Q: What do doctors typically charge for Injection Fosaprepitant Teva Not Therapeutically Equivalent to J1453 1 Mg?

The nationwide median physician charge for Injection Fosaprepitant Teva Not Therapeutically Equivalent to J1453 1 Mg (HCPCS J1456) is $3.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg. Clinical pricing breakdown and utilization metrics across 8 practicing doctors nationwide.

$3.00

Peer Median Charge

Gross billed rate

$0.33

Standard Baseline

Customary allowable

9.1x

National Markup

Charge vs baseline

Active Physicians

Billing this code

Planning care or already received a bill for CPT J1456?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $3.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $0.33 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code J1456 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"