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Iowa rates for HCPCS B9004

Parenteral Nutrition Infusion Pump Portable (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,543.63 / $2,543.63 / $2,543.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,374.18 / $2,717.01 / $3,484.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,682.58 / $4,243.88 / $5,304.84
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$576.00 / $579.51 / $5,067.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$637.46 / $3,643.96 / $17,132.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.27 / $2,587.32 / $4,766.47
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.60 / $695.41 / $1,506.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.60 / $764.01 / $1,220.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,826.34 / $2,587.32 / $5,188.81
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.73 / $3,294.73 / $3,294.73
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,294.73 / $3,294.73 / $3,294.73