go back

Indiana 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
$0.39 / $0.44 / $0.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.44 / $0.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.35 / $0.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.49 / $0.73