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Minnesota 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
$0.54 / $0.54 / $0.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.54 / $0.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.59 / $0.65 / $0.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.70 / $0.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $1.19 / $2.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.44 / $0.48
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $1.09 / $2.25
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.85 / $3.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.55 / $1.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.53 / $1.12