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Michigan 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
$23.47 / $23.47 / $66.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.24 / $23.47 / $23.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.86 / $69.31 / $133.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.43 / $24.66 / $24.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.57 / $18.53 / $20.35
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.80 / $17.80 / $23.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.24 / $21.59 / $28.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $19.29 / $30.57