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Virginia 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
$205.96 / $205.96 / $317.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.39 / $205.96 / $317.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.24 / $333.24 / $353.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.43 / $325.43 / $325.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.00 / $180.00 / $180.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $153.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.25 / $389.89 / $493.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.61 / $219.69 / $345.73
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.84 / $124.84 / $168.93
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.23 / $312.74 / $9,929.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.23 / $312.74 / $9,929.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.79 / $262.36 / $477.02