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New Hampshire rates for HCPCS B4105

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

Insurance Carrier
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.00 / $53.00 / $53.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $81.59 / $81.59
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.19 / $174.06 / $217.58
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.18 / $122.30 / $155.65