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West 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
$141.25 / $141.25 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $245.47 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $239.88 / $389.05