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North Carolina 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
$355.26 / $355.26 / $355.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.26 / $355.26 / $355.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.27 / $369.60 / $741.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.29 / $304.29 / $324.58
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.30 / $355.26 / $426.31
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.89 / $304.89 / $304.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.41 / $337.35 / $1,023.25
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$633.94 / $1,927.17 / $1,927.17