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Louisiana 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
$350.78 / $366.20 / $385.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.78 / $385.47 / $385.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.74 / $242.74 / $364.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.14 / $280.68 / $287.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $208.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.19 / $305.74 / $417.66