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Nevada 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
$1.54 / $1.54 / $1.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.56 / $5.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.54 / $1.54 / $1.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.28 / $2.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.47 / $2.47 / $14.12
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.54 / $2.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $1.80 / $2.64