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Iowa rates for HCPCS B4164

Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit), home mix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.13 / $17.13 / $17.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.26 / $18.30 / $23.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.50 / $28.50 / $35.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.51 / $28.84 / $52.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.94 / $31.68 / $115.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.61 / $25.38 / $41.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.05 / $27.50 / $33.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.85 / $31.03 / $51.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $18.44 / $34.95
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.66 / $24.66 / $24.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.66 / $24.66 / $24.66