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Maine rates for HCPCS B4161

Enternal Formula For Pediatrics Hydrolyzed/Amino Acids And Peptide Chain

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.84 / $2.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $1.87 / $2.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.84 / $2.84