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Colorado rates for HCPCS B4152

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.82 / $0.82 / $0.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.24 / $0.56 / $0.76
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.52 / $0.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.55 / $0.88