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Minnesota 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
$281.89 / $386.17 / $386.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$347.55 / $376.40 / $564.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.58 / $405.72 / $405.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,019.14 / $1,445.27 / $3,476.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.95 / $532.40 / $597.22
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$802.47 / $1,321.32 / $2,737.63
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.25 / $470.25 / $639.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.62 / $405.72 / $823.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.41 / $405.72 / $969.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.47 / $401.95 / $969.44