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Hawaii rates for HCPCS B4153

Enteral Formula Nutritionally Complete Hydrolyzed Proteins (Amino Accis And Ing Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130

Insurance Carrier
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.18 / $2.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.69