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New Jersey 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
$110.01 / $122.21 / $122.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.01 / $122.59 / $280.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $225.00 / $225.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $215.34
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.66 / $221.66 / $221.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.57 / $172.90 / $445.69