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Missouri 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
$2,648.16 / $3,031.45 / $3,484.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,648.16 / $3,031.45 / $3,484.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,660.81 / $3,843.85 / $16,898.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,829.31 / $1,868.90 / $3,011.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $4,286.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $5,804.84 / $17,132.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,810.05 / $2,311.51 / $4,264.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,810.05 / $2,392.17 / $6,009.93