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Minnesota 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 / $0.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.44 / $0.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.53 / $0.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.56 / $0.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.84 / $1.19 / $2.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.44 / $0.48
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $1.09 / $2.25
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.57 / $3.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.45 / $1.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.44 / $0.95