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Georgia 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
$20.13 / $20.13 / $29.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.13 / $20.54 / $23.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.66 / $39.46 / $90.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.59 / $20.50 / $38.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.52 / $38.22 / $48.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.35 / $20.35 / $27.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.47 / $24.66 / $98.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $24.93 / $35.35