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Wyoming 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
$0.42 / $0.42 / $0.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.57 / $0.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.63 / $1.61