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Iowa 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
$179.20 / $179.20 / $179.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.81 / $191.41 / $245.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.88 / $298.88 / $373.59
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.31 / $257.89 / $466.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.91 / $331.40 / $1,206.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.88 / $265.36 / $431.53
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.87 / $287.69 / $354.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.53 / $322.54 / $542.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.66 / $214.44 / $450.32
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.89 / $257.89 / $257.89
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.89 / $257.89 / $257.89