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Oklahoma 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
$214.54 / $214.54 / $214.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.54 / $214.54 / $225.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.83 / $225.83 / $225.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $119.00 / $119.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.85 / $237.12 / $523.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.78 / $184.15 / $256.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.78 / $184.15 / $256.83