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Florida rates for HCPCS B4153

Enteral Formula Nutritionally Complete Hydrolyzed Proteins (Amino Accis And Ing Tube 100 Calories = 1 Unit (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.85 / $1.21 / $1.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.21 / $1.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.47 / $2.47 / $2.47
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.53 / $1.59 / $2.72
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $0.91 / $1.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $1.61 / $3.03
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51