go back

Illinois 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 / $83.71 / $175.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $81.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.44 / $229.71 / $741.41
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $87.78 / $233.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.94 / $64.94 / $64.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $58.75