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Illinois 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
$316.23 / $316.23 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $275.42 / $316.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $616.60 / $2,951.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $398.11 / $562.34
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $436.52 / $436.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $275.42 / $446.68