go back

Maine rates for HCPCS J3475

Injection, magnesium sulfate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.47 / $38.02 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $1.58 / $1.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.43 / $0.52
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.47 / $38.02 / $97.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $1.23 / $5.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.72