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Alabama rates for HCPCS B4189

Parenteral Nutrition Solution; Compounded Amino Acid And Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Any Strength 10 To 51 Grams Of Protein - Premix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.50 / $135.50 / $135.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.81 / $135.50 / $210.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.00 / $165.00 / $165.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $119.00 / $144.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.78 / $204.06 / $232.61