go back

Rhode Island rates for HCPCS J3475

Injection Magnesium Sulfate Per 500 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.69 / $25.38 / $90.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.50 / $0.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.48 / $0.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.48 / $0.48