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Montana rates for HCPCS B4168

Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $28.84 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $61.66 / $61.66
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $61.66 / $61.66
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $38.02 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $46.77 / $52.48