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Massachusetts 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
$176.77 / $176.77 / $176.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.77 / $176.77 / $295.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.19 / $452.73 / $1,320.61
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $409.58 / $522.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$751.53 / $886.53 / $1,963.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $35.00 / $37.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $208.25
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.24 / $417.24 / $866.52
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $941.11 / $2,202.10
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.84 / $315.19 / $649.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $315.19 / $595.70