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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 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
$335.36 / $383.90 / $441.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.36 / $383.90 / $441.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.60 / $486.78 / $2,139.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.55 / $226.16 / $381.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $542.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.19 / $941.11 / $2,169.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.22 / $292.73 / $540.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.50 / $271.64 / $706.76