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Iowa 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
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $269.15 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $478.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $380.19 / $537.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $416.87 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $363.08 / $575.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $426.58 / $457.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $275.42 / $575.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13