| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $90.33 | $90.33 | $122.06 | |
Cigna
| Professional | $119.00 | $119.00 | $119.00 | |
United
| Professional | $145.35 | $187.15 | $630.64 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $90.33 | $90.33 | $122.06 | |
Cigna
| Professional | $119.00 | $119.00 | $119.00 | |
United
| Professional | $145.35 | $187.15 | $630.64 |