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Minnesota rates for HCPCS B4162

Enternal Formula For Pediatrics Special Metabolic Needs For Inherited Disease

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.73 / $0.73 / $0.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.47 / $6.08 / $1,061.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $5.47 / $6.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.52 / $3.58 / $8.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.32 / $1.43
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $3.28 / $6.79
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $3.88 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.94 / $2.94 / $2.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.94 / $2.94 / $2.94