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Louisiana rates for HCPCS B4150

Enteral Formula Nutritionally Complete With Intact Nutrients Includes N Enteral Feeding Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 65-10 A

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.43 / $0.45 / $0.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.43 / $0.47 / $0.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.45 / $0.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.29 / $101.29 / $101.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.52 / $0.86