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Washington, DC 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
$386.17 / $386.17 / $386.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.17 / $386.17 / $386.17
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.16 / $213.16 / $213.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.72 / $405.72 / $805.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.94 / $217.78 / $992.08