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West Virginia rates for HCPCS B4187

Omegaven, 10 g lipids

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.85 / $6.85 / $6.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.85 / $15.51 / $15.51
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.98 / $21.17 / $24.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.57 / $116.57 / $116.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.47 / $13.47 / $78.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.81 / $12.87 / $22.81