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Massachusetts rates for HCPCS B4161

Enternal Formula For Pediatrics Hydrolyzed/Amino Acids And Peptide Chain

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.78 / $4.32 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $1.78 / $1.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.21 / $3.78 / $8.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $100.00