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Nebraska 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
$3,484.42 / $3,484.42 / $3,484.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,543.63 / $3,484.42 / $10,562.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,396.85 / $1,837.24 / $3,839.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,396.26 / $3,539.26 / $3,575.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,917.18 / $4,243.88 / $5,304.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.60 / $3,484.42 / $17,132.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.77 / $3,043.90 / $6,223.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.60 / $744.65 / $1,448.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.60 / $744.65 / $4,184.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.77 / $3,043.90 / $4,676.89