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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
$127.07 / $149.62 / $149.62
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.48 / $383.99 / $442.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.93 / $333.24 / $333.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $153.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.92 / $299.92 / $359.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.07 / $149.62 / $149.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.31 / $355.95 / $421.87