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Arizona rates for HCPCS B4193

Parenteral nutrition solution: compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 g of protein, premix

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.61 / $186.61 / $961.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.44 / $983.29 / $1,638.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.94 / $303.91 / $605.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $153.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.24 / $333.24 / $1,559.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.73 / $253.36 / $416.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.27 / $253.36 / $445.78