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Oklahoma 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
$0.47 / $0.47 / $0.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.47 / $0.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $0.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.61 / $1.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.48 / $0.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.46 / $0.91