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Montana 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
$291.79 / $961.47 / $961.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.43 / $325.43 / $325.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.90 / $349.90 / $349.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.90 / $349.90 / $349.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.90 / $349.90 / $349.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.15 / $262.61 / $317.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.84 / $429.94 / $491.36