go back

Oregon 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
Professional
Modifier
Low / Median / High Price
$96.81 / $214.87 / $744.11
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
$245.26 / $546.15 / $654.49
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.39 / $257.89 / $307.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.01 / $251.86 / $273.37
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.11 / $251.86 / $335.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.64 / $10.48 / $307.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $119.00 / $283.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$364.49 / $697.39 / $1,004.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.00 / $196.00 / $206.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.12 / $368.40 / $659.62