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Minnesota 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 Grams Of Protein - Premix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.18 / $317.18 / $317.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.54 / $317.18 / $317.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.45 / $309.16 / $464.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.58 / $333.24 / $333.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.21 / $1,187.27 / $2,856.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.11 / $437.36 / $490.54
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.22 / $1,085.45 / $2,248.92
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.25 / $386.25 / $525.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.76 / $333.24 / $676.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.25 / $333.24 / $796.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.16 / $345.18 / $673.53