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Connecticut 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
$0.25 / $0.25 / $0.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.31 / $0.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.39 / $0.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.55 / $0.68