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Arizona 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 g of protein, premix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.41 / $144.41 / $144.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.41 / $144.41 / $744.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.80 / $760.91 / $1,267.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.71 / $235.21 / $468.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $119.00 / $119.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.79 / $257.89 / $1,206.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.02 / $196.08 / $322.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.61 / $194.47 / $322.39