go back

Iowa rates for HCPCS B4199

Parenteral Nutrition Solution; Compounded Amino Acid And Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Any Strength Over 100 Grams Of Protein - Premix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.12 / $322.12 / $322.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.03 / $344.07 / $441.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.38 / $537.38 / $671.72
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.07 / $463.60 / $641.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.57 / $595.70 / $2,169.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.06 / $477.05 / $775.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.47 / $517.13 / $637.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.78 / $579.67 / $974.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $385.47 / $599.79
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.60 / $463.60 / $463.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.60 / $463.60 / $463.60