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South Dakota rates for HCPCS B4168

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.22 / $34.22 / $34.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.22 / $34.22 / $35.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.63 / $42.04 / $52.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.64 / $50.22 / $96.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.96 / $34.36 / $60.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.44 / $40.10 / $46.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.64 / $45.45 / $75.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.11 / $35.96 / $47.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.96 / $26.87 / $60.14
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $35.96 / $35.96