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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
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.39 / $0.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.62 / $1.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.34 / $0.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.51 / $1.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $2.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.43 / $98.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.61 / $0.93