go back

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 g of protein - premix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $269.15 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $169.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $870.96 / $1,023.29
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $389.05 / $478.63
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $389.05 / $426.58
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $407.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.62 / $251.19 / $478.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $169.82 / $436.52
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $776.25 / $1,584.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $588.84 / $1,047.13