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Nebraska 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 $617 · 10th–90th $0–$1,2590%10%10th90th$617Professionalmedian $1 · 10th–90th $0–$20%20%40%10th90th$1$0.2$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. 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
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $794.33 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.37 / $0.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.38 / $0.47 / $0.62
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.44 / $0.72 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.18 / $0.38 / $1.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.62 / $0.72 / $0.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.39 / $0.39 / $0.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.17 / $0.38 / $1.26