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Missouri 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
$293.49 / $335.97 / $386.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.49 / $335.97 / $386.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.72 / $426.01 / $1,872.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.13 / $180.60 / $376.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $170.00 / $474.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.88 / $823.61 / $1,898.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.60 / $256.17 / $472.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.94 / $243.91 / $618.53