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Montana 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

Facilitymedian $1 · 10th–90th $0–$10%50%10th90th$1Professionalmedian $1 · 10th–90th $0–$20%20%10th90th$1$0.2$1.0$5.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.66 / $1.66 / $1.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.56 / $0.56 / $0.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.39 / $0.56 / $0.58
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.39 / $0.56 / $0.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.49 / $0.62 / $0.89