go back

Idaho 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
$186.21 / $275.42 / $288.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $398.11 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $398.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $323.59 / $323.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $323.59 / $338.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $501.19 / $691.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $338.84
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $338.84 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $295.12 / $436.52