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Tennessee 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
$277.63 / $277.63 / $485.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.23 / $277.63 / $291.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $153.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.69 / $1,559.56 / $1,582.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.83 / $269.88 / $553.96