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Michigan rates for HCPCS B4105

In-line cartridge containing digestive enzyme(s) for enteral feeding, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.00 / $404.00 / $404.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.34 / $154.34 / $154.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.00 / $110.00 / $110.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $81.59 / $81.59
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $120.00 / $120.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.34 / $154.34 / $404.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00