| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.64 | $8.64 | $11.67 | |
Cigna
| Professional | $20.35 | $20.35 | $20.35 | |
United
| Professional | $13.90 | $17.91 | $60.29 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.64 | $8.64 | $11.67 | |
Cigna
| Professional | $20.35 | $20.35 | $20.35 | |
United
| Professional | $13.90 | $17.91 | $60.29 |