go back

South Carolina 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
$2,233.09 / $3,205.54 / $3,484.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,908.18 / $3,660.81 / $4,576.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,650.67 / $3,484.42 / $4,703.97
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,454.09 / $1,454.09 / $1,454.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,217.56 / $2,836.83 / $3,469.26