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Arkansas rates for HCPCS B4164

Parenteral Nutrition Solution: Carbohydrates (Dextrose) 50% Or Less (500 Ml = 1 Unit) - Homemix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.86 / $19.86 / $19.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.25 / $19.86 / $20.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179,999.82 / $489,999.51 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.97 / $23.78 / $23.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.35 / $20.35 / $20.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.19 / $18.53 / $24.25