go back

Utah 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 / $1.13