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Massachusetts 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
$0.34 / $0.34 / $0.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.34 / $0.36
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.53 / $90.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.45 / $1.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $1.04 / $2.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.34 / $0.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $0.93 / $90.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.64 / $1.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.64 / $1.00