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North Dakota 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 / $0.33 / $0.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.36 / $0.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.56 / $0.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.41 / $0.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.38 / $0.68