go back

Maine 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
Professional
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.45 / $0.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.32 / $0.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.25 / $0.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.61 / $0.75