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Missouri 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
$275.42 / $275.42 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $275.42 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $177.83 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $389.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $524.81 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $208.93 / $389.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $331.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $218.78 / $398.11