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Minnesota rates for HCPCS J0476

Injection, baclofen, 50 mcg for intrathecal trial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $60.26 / $79.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $61.66 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $131.83 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $70.79 / $77.62
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $125.89 / $147.91
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $83.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $93.33 / $114.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $67.61 / $91.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $58.88 / $104.71