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Wisconsin 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%50%90th$0Professionalmedian $0 · 10th–90th $0–$10%20%40%10th90th$0$0.2$1.0$5.0$20.0$100.0

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 / $3.98 / $7.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.48 / $0.48 / $0.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.45 / $0.45 / $0.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.89 / $1.05 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.47 / $0.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.37 / $0.46 / $0.76
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.26 / $0.26 / $0.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.37 / $0.46 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.28 / $0.76 / $1.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $64.57 / $89.13
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.41
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $1.12
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.37 / $0.71 / $1.07
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $89.13 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.33 / $0.33 / $0.33
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.38 / $0.48 / $0.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.19 / $0.71 / $1.74