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Maryland 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
Professional
Modifier
Low / Median / High Price
$159.40 / $245.48 / $338.76
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $135.50 / $135.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $119.00 / $119.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.22 / $283.69 / $386.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.66 / $180.93 / $561.27
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.90 / $129.90 / $129.90