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Wisconsin rates for HCPCS B4105

In-Line Cartridge Containing Digestive Enzyme(S) For Enteral Feeding Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.34 / $154.34 / $523.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.09 / $50.40 / $67.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.75 / $513.88 / $788.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $188.49 / $228.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.62 / $578.78 / $578.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.43 / $323.43 / $323.43
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.19 / $131.19 / $578.78
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.59 / $81.59 / $81.59