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Kentucky 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
$155.88 / $260.33 / $441.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.88 / $344.07 / $441.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.60 / $463.60 / $463.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.55 / $305.36 / $305.36
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.48 / $333.48 / $668.43
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.33 / $509.96 / $784.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$543.28 / $543.28 / $543.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.99 / $2,234.55 / $2,234.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.76 / $341.09 / $497.72