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Wisconsin rates for HCPCS B4222

Parenteral nutrition supply kit; home mix, per day

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $10.96 / $12.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $14.45 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $16.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $45.71 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $20.42 / $27.54
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $14.45 / $15.14
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $5.13 / $5.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $14.45 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $14.45 / $35.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $22.39 / $45.71
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $85.11 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $5.89 / $5.89
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $14.45 / $14.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $14.45 / $14.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.45 / $14.45 / $14.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $13.18 / $37.15