go back

Florida rates for HCPCS B4149

Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.02 / $1.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.72 / $6.17
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.24 / $2.24
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $0.78 / $1.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.02 / $1.29 / $1.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.38 / $2.34
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.62