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West Virginia rates for HCPCS J0475

Injection, baclofen, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.21 / $89.21 / $183.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.21 / $181.22 / $201.33
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.22 / $271.83 / $271.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.96 / $177.87 / $181.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.22 / $181.22 / $335.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.78 / $181.22 / $255.87