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Montana rates for HCPCS B5000

Parenteral Nutrition Solution Compounded Amino Acid Carbohydrates With Electrolytes Trace Elements And Vitamins Including Preparation Anystrength Renal-Aminosyn-Rf Nephramine Renamine-Premix (Revised 01/01/2016) I

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.11 / $49.79 / $49.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.11 / $18.11 / $18.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.11 / $18.11 / $18.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.11 / $18.11 / $18.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.60 / $13.60 / $18.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.69 / $23.06 / $25.45