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Connecticut rates for HCPCS J0476

Injection Baclofen 50 Mcg For Intrathecal Trial (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.95 / $97.94 / $149.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.95 / $51.95 / $51.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.44 / $86.27 / $172.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.83 / $54.19 / $62.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.45 / $49.95 / $63.59