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Nebraska 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
$317.18 / $317.18 / $317.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.54 / $317.18 / $961.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,396.85 / $1,837.24 / $3,839.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.16 / $322.18 / $325.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.58 / $386.25 / $482.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$222.56 / $428.19 / $1,559.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.87 / $277.08 / $566.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.49 / $416.75 / $458.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.00 / $416.75 / $700.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.87 / $263.23 / $566.50