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Idaho 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.68 / $1.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.42 / $2.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.41 / $0.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.41
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.41 / $0.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.58 / $0.93