| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $167.52 | $167.52 | $386.17 | |
BCBS
| Facility | $573.61 | $774.77 | $917.23 | |
BCBS
| Professional | $223.00 | $318.57 | $519.01 | |
United
| Professional | $134.94 | $284.63 | $480.24 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $167.52 | $167.52 | $386.17 | |
BCBS
| Facility | $573.61 | $774.77 | $917.23 | |
BCBS
| Professional | $223.00 | $318.57 | $519.01 | |
United
| Professional | $134.94 | $284.63 | $480.24 |