go back

Washington rates for HCPCS J0476

Injection, baclofen, 50 mcg for intrathecal trial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.96 / $134.40 / $799.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $54.95 / $109.73
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.83 / $49.95 / $273.30
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $49.95 / $49.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.12 / $47.12 / $107.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $61.26
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.95 / $71.15 / $139.47
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.83 / $32.83 / $43.03
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.56 / $43.03 / $46.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.95 / $49.95 / $147.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.95 / $49.95 / $49.95