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Minnesota 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
$1.13 / $1.13 / $1.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.13 / $1.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.23 / $1,061.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.84 / $3.55 / $3.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.05 / $7.17 / $17.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.64 / $2.86
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.11 / $6.55 / $13.58
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $3.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.93 / $3.24 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.38