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Missouri rates for HCPCS B4199

Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 g of protein - premix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $380.19 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $467.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $1,621.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $537.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $741.31 / $2,187.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $295.12 / $537.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $371.54 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $302.00 / $562.34