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Minnesota 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
$441.26 / $441.26 / $441.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.12 / $441.26 / $441.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.13 / $430.09 / $645.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.88 / $463.60 / $463.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,164.84 / $1,651.90 / $3,973.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$542.75 / $608.52 / $682.47
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$917.21 / $1,510.24 / $3,129.04
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.38 / $537.38 / $730.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.16 / $463.60 / $941.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $463.60 / $1,107.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.09 / $412.68 / $1,107.73