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Maryland rates for HCPCS B4162

Enternal Formula For Pediatrics Special Metabolic Needs For Inherited Disease

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.73
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.56 / $3.56 / $3.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.02 / $1.02 / $1.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $12.00 / $12.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.47 / $2.47 / $2.47