| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $137.60 | $137.60 | $317.18 | |
BCBS
| Facility | $471.15 | $636.35 | $753.37 | |
BCBS
| Professional | $179.40 | $256.27 | $417.53 | |
United
| Professional | $166.25 | $250.44 | $394.46 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $137.60 | $137.60 | $317.18 | |
BCBS
| Facility | $471.15 | $636.35 | $753.37 | |
BCBS
| Professional | $179.40 | $256.27 | $417.53 | |
United
| Professional | $166.25 | $250.44 | $394.46 |