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Nebraska rates for HCPCS J3475

Injection, magnesium sulfate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $63.26 / $292.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $2.81 / $9.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.41 / $0.52 / $0.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.54 / $0.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $0.96 / $0.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.53 / $0.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $14.36 / $38.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.50 / $0.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.60 / $0.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.65 / $1.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.48 / $0.53