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Oregon 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
Professional
Modifier
Low / Median / High Price
$0.33 / $0.47 / $1.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.71 / $0.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.67 / $1.01
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.48 / $0.65
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.47 / $0.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.51 / $0.78 / $1.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.70 / $0.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $0.70 / $2.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.37 / $0.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.84 / $1.45