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Oregon 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
Professional
Modifier
Low / Median / High Price
$152.30 / $338.02 / $1,170.59
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
$385.91 / $859.35 / $1,029.81
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.57 / $405.72 / $483.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.43 / $396.21 / $430.06
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.15 / $396.21 / $527.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.61 / $13.29 / $483.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.61 / $170.00 / $446.29
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.75 / $1,098.44 / $1,581.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.35 / $308.35 / $324.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.93 / $593.77 / $1,037.67