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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$137.60 / $137.60 / $317.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$471.15 / $636.35 / $753.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.40 / $256.27 / $417.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.25 / $250.44 / $394.46