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Mississippi 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
$225.83 / $225.83 / $225.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.50 / $225.83 / $225.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.84 / $209.84 / $230.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.85 / $199.85 / $199.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $119.00 / $119.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.78 / $228.68 / $347.39