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Vermont 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
$212.66 / $212.66 / $212.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $208.52
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.52 / $208.52 / $208.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.25 / $325.14 / $385.25