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Idaho rates for HCPCS B4199

Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 g of protein - premix

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.29 / $405.94 / $405.94
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.96 / $405.94 / $580.49
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.42 / $440.42 / $463.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.46 / $690.56 / $1,014.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.52 / $324.52 / $463.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.09 / $408.69 / $659.66