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Hawaii 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
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $1.70 / $1.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $1.87 / $2.17