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Maine 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
$125.89 / $204.17 / $660.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $389.05 / $446.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $338.84 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $363.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $204.17 / $660.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $302.00 / $426.58