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Hawaii 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

Professionalmedian $1 · 10th–90th $1–$10%50%$1$1.0

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
$1.45 / $1.45 / $1.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $0.65
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.78 / $0.78