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West Virginia 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
$108.40 / $108.40 / $108.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.40 / $159.40 / $245.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.29 / $329.33 / $386.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.23 / $302.23 / $302.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.00 / $119.00 / $1,243.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.38 / $193.00 / $361.06