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Virginia 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
$286.52 / $286.52 / $441.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.43 / $286.52 / $441.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.60 / $463.60 / $492.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.16 / $226.16 / $226.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $245.00 / $245.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.25 / $208.25 / $208.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.97 / $542.41 / $686.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.70 / $305.62 / $480.97
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.74 / $173.74 / $235.11
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.42 / $419.99 / $9,929.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.42 / $419.99 / $9,929.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.46 / $309.77 / $643.73