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Oregon 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
$0.27 / $0.38 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.71 / $0.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.54 / $0.82
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.37 / $0.52
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.40 / $0.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.40 / $0.71 / $1.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.59 / $0.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.61 / $1.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.71 / $1.38