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Georgia 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
$49.95 / $67.20 / $105.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $50.45 / $81.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.95 / $54.20 / $54.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $50.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.95 / $49.95 / $97.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.12 / $47.12 / $49.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.80 / $91.79 / $91.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $69.12