| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.39 | $11.39 | $11.39 | |
Aetna
| Professional | $11.39 | $11.39 | $29.49 | |
Regence BlueShield
| Facility | $38.94 | $50.45 | $52.07 | |
United
| Professional | $20.74 | $34.00 | $47.30 |
Parenteral Nutrition Solution; Carbohydrates (Dextrose) Greater Than 50% (500 Ml=1 Unit) - Homemix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.39 | $11.39 | $11.39 | |
Aetna
| Professional | $11.39 | $11.39 | $29.49 | |
Regence BlueShield
| Facility | $38.94 | $50.45 | $52.07 | |
United
| Professional | $20.74 | $34.00 | $47.30 |