go back

Illinois 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
$0.44 / $0.44 / $0.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.38 / $0.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.63 / $2.42 / $6.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.59 / $3.57
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.51 / $0.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.51 / $0.97