go back

Montana 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
Professional
Modifier
Low / Median / High Price
$405.94 / $1,337.58 / $1,337.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.73 / $452.73 / $452.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$486.78 / $486.78 / $486.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.78 / $486.78 / $486.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$486.78 / $486.78 / $486.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.83 / $365.35 / $441.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.00 / $598.13 / $683.58