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Oklahoma 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
$277.20 / $277.20 / $277.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.20 / $277.20 / $291.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.79 / $291.79 / $291.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $153.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.39 / $306.38 / $676.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.83 / $237.97 / $331.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.83 / $249.17 / $331.90