go back

Minnesota 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
$23.47 / $23.47 / $23.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.13 / $23.47 / $23.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.12 / $22.88 / $34.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.73 / $24.66 / $24.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.33 / $88.39 / $212.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.79 / $32.56 / $36.20
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.08 / $80.81 / $167.43
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.50 / $28.50 / $38.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.51 / $25.89 / $50.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $24.66 / $58.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.63 / $24.43 / $49.83