go back

Michigan rates for HCPCS J3475

Injection, magnesium sulfate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.75 / $9.73 / $90.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.52 / $3.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $1.11 / $2.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.66 / $0.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.48 / $0.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $9.34 / $94.90
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.50 / $3.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.56 / $0.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.51