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Kansas 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.57 / $0.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.44 / $0.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $0.67 / $0.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.66 / $0.66 / $0.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.34 / $0.51 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.59 / $0.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.40 / $0.87