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Hawaii 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 g of protein - premix

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $245.47 / $338.84
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $446.68 / $501.19