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Pennsylvania rates for HCPCS J0475

Injection, baclofen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.10 / $411.42 / $534.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.21 / $183.03 / $1,170.94
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.12 / $196.61 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.06 / $188.06 / $188.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.96 / $181.22 / $181.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.22 / $181.22 / $181.22
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$764.39 / $764.39 / $764.39
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.58 / $411.42 / $3,266.16
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.58 / $201.33 / $534.49
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.96 / $181.22 / $181.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.22 / $181.22 / $181.22
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.92 / $185.92 / $215.74
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.92 / $185.92 / $215.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.22 / $181.22 / $255.94