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Massachusetts rates for HCPCS J3475

Injection Magnesium Sulfate Per 500 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $9.36 / $62.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.50 / $0.65
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $1.11 / $75.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $1.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $0.61 / $1.31
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 / $0.48
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $83.43 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $1.02
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.49 / $14.28 / $173.32
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $1.56
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.67 / $0.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $1.56