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Pennsylvania rates for HCPCS B4150

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Facilitymedian $1 · 10th–90th $1–$8,5110%20%40%10th90th$1Professionalmedian $1 · 10th–90th $0–$20%20%40%10th90th$1$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $0.45 / $0.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $0.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.49 / $0.62 / $0.98
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.41 / $0.62 / $0.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.58 / $0.93