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Georgia 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
Professional
Modifier
Low / Median / High Price
$1.20 / $1.20 / $1.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $37.15 / $57.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $1.20 / $1.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.34 / $1.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $2.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.40 / $1.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.40 / $0.40 / $0.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.62 / $0.93