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Pennsylvania 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
$267.92 / $267.92 / $324.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.85 / $296.33 / $1,337.58
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.60 / $463.60 / $463.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $208.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.92 / $267.92 / $324.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.85 / $296.33 / $1,337.58
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $208.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.45 / $441.26 / $441.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.45 / $441.26 / $441.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.28 / $382.03 / $664.36