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North Carolina rates for HCPCS J3475

Injection, magnesium sulfate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.15 / $37.69 / $123.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.79 / $3.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $1.25 / $1.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.53
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 / $0.55
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.66 / $0.79
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.74
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00