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Mississippi 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
$52.45 / $59.94 / $80.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $52.45 / $67.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.08 / $70.08 / $77.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.95 / $49.95 / $83.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.95 / $49.95 / $63.94