go back

Kentucky 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
$0.26 / $0.28 / $0.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.28 / $0.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.60 / $0.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.31 / $0.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.69 / $0.69 / $0.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $1.93 / $3.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.16 / $0.53 / $0.84