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New York 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
$0.26 / $0.28 / $0.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.28 / $0.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.37 / $0.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.80 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.57 / $1.06
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.45 / $0.48
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.48 / $0.52
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $74,999.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.51 / $0.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.49 / $0.84
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.48 / $0.48 / $0.52
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.52 / $0.52