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Connecticut rates for HCPCS B4197

Parenteral Nutrition Solution; Compounded Amino Acid And Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Any Strength 74 To 100 Grams Of Protein - Premix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.61 / $258.61 / $258.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.52 / $301.12 / $386.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.43 / $405.72 / $464.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.26 / $336.77 / $396.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.40 / $306.32 / $525.26