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New Hampshire rates for HCPCS J3475

Injection, magnesium sulfate, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.72 / $9.55 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $5.62 / $21.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.58 / $0.85 / $1.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.41 / $0.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.41
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.72 / $0.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.81