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Massachusetts 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
Facility
Modifier
Low / Median / High Price
$154.69 / $154.69 / $154.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.69 / $154.69 / $258.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$286.50 / $396.21 / $1,155.74
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.41 / $358.43 / $456.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.53 / $775.64 / $1,718.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $35.00 / $37.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $170.00 / $170.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.15 / $365.15 / $758.34
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $823.61 / $1,927.17
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.76 / $275.82 / $568.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.41 / $287.33 / $568.01