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North Carolina 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
$405.94 / $405.94 / $405.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.52 / $405.94 / $405.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.33 / $422.33 / $846.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.70 / $347.70 / $370.88
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.04 / $405.94 / $487.13
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.40 / $348.40 / $348.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $385.47 / $1,169.22
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.37 / $2,202.10 / $2,202.10