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Tennessee 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 / $1.66 / $1.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $40.74 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.58 / $89.13 / $89.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.30 / $0.40 / $0.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.55 / $1.00