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Massachusetts 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
$1,395.93 / $1,395.93 / $1,395.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,395.93 / $1,395.93 / $2,333.46
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,439.05 / $3,575.01 / $10,164.04
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,145.01 / $3,484.42 / $4,040.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,239.03 / $5,010.06 / $6,456.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,104.79 / $2,510.66 / $2,510.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $1,275.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,571.53 / $3,571.53 / $7,417.35
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $7,431.44 / $17,388.84
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,712.23 / $2,488.89 / $5,125.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,712.23 / $2,323.73 / $4,122.54