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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
$242.45 / $291.79 / $291.79
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.38 / $291.79 / $417.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.58 / $316.58 / $333.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.60 / $496.32 / $729.51
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.27 / $233.27 / $333.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.16 / $291.75 / $436.55