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Indiana rates for HCPCS J3475

Injection, magnesium sulfate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $44.76 / $99.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.49 / $1.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.96 / $1.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.48 / $0.68
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $1.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.82