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Maryland 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
$250.76 / $386.17 / $532.91
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.16 / $213.16 / $213.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $170.00 / $170.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.86 / $446.29 / $608.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.18 / $284.00 / $580.60
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.36 / $204.36 / $204.36