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Washington 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 $0 · 10th–90th $0–$10%20%40%10th90th$0Professionalmedian $1 · 10th–90th $0–$20%20%10th90th$1$0.2$1.0$5.0$20.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $0.50 / $1.02
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.40 / $0.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $0.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.46 / $0.46 / $0.47
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.49 / $0.71 / $0.98
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $0.45 / $0.45
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.41 / $0.50 / $1.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.40 / $0.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.38 / $0.38 / $0.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.51 / $0.91 / $1.48
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.40 / $0.71