go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$286.52 / $441.26 / $608.94
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.56 / $243.56 / $243.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $208.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.06 / $509.96 / $695.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.46 / $324.52 / $663.42
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.35 / $92.35 / $233.51