go back

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
Professional
Modifier
Low / Median / High Price
$1.45 / $1.45 / $1.66
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
$0.34 / $0.47 / $0.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.69 / $0.69 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $1.95
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.65 / $1.51
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.58 / $1.12
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
$0.98 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.48 / $0.93
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.45 / $0.48 / $0.52
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $0.48 / $0.54