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Idaho 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
Professional
Modifier
Low / Median / High Price
$0.33 / $0.42 / $0.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.45 / $2.47
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.40 / $0.42
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.51 / $0.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.50 / $0.94