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Iowa rates for HCPCS B4152

Enteral Formula Nutritionally Complete Calorically Dense (Equal To Or Greater Ough An Enteral Feeding Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 6

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $0.57 / $0.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.38 / $0.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.47 / $0.49
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.71 / $1.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.79 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.62 / $1.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.62 / $0.65 / $0.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $0.73 / $1.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.38 / $0.83
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56